Individual
MRS. PAMELA BOND PONICHTERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.P.R.N.
Contact information
Practice address
500 ALBANY AVENUE, PEDIATRIC CLINIC, HARTFORD, CT 06120
(860) 249-9625
(860) 808-1542
Mailing address
8 COBBS RD, WEST HARTFORD, CT 06107-1401
(860) 521-2430
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
001273
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004151916
—
CT
Enumeration date
10/19/2006
Last updated
11/22/2011
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