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Organization

MELISSA BONASERA, MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA BONASERA (MANAGER)
(203) 364-0660
Entity
Organization

Contact information

Practice address
103 S MAIN ST, NEWTOWN, CT 06470-2372
(203) 364-0660
Mailing address
PO BOX 322, NEWTOWN, CT 06470-0322
(203) 364-0660

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
2084P0800X
Psychiatry Physician
045981
CT
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
045981
CT

Other

Enumeration date
10/29/2009
Last updated
10/29/2009
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