Individual
DR. VIRGINIA ANN BONOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
120 STOCKWELL DR, AVON, MA 02322-1149
(508) 232-4012
(508) 232-4013
Mailing address
120 STOCKWELL DR, AVON, MA 02322-1149
(508) 837-3790
(508) 484-2008
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3404
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5031433
AETNA
MA
01
—
W16552
BC/BS
MA
Enumeration date
02/27/2007
Last updated
04/20/2020
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