Bonilla, Melissa

Bonilla, Melissa is an individual health care provider with primary practice located at 501 Kings Hwy E Ste 106 , Fairfield CT 06825-4871. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bonilla, Melissa can be contacted via phone (203) 819-1203.

Contact Information

Primary practice address
501 Kings Hwy E Ste 106 Fairfield CT 06825-4871
Phone: (203) 819-1203
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 001589 Connecticut

Profile Details

NPI number 1578562526
LBN Legal business name Bonilla, Melissa
Credentials PHYSICIAN ASSISTANT
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2005
Last updated Apr 29th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578562526 NPPES
Connecticut Other 001589 STATE LICENSE

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