Individual
BONA EZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1680 ALBANY AVE, HARTFORD, CT 06105-1001
(860) 236-4511
Mailing address
1680 ALBANY AVE, HARTFORD, CT 06105-1001
(860) 236-4511
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
83716
CT
Other
Enumeration date
01/24/2018
Last updated
01/24/2018
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