Individual
NICHOLAS BONOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
56 FRANKLIN ST, WATERBURY, CT 06706-1253
(203) 709-6000
Mailing address
46 S CHERRY ST, UNIT 244, WALLINGFORD, CT 06492-3596
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
1090862
CT
Other
Enumeration date
01/27/2010
Last updated
10/19/2021
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