Active NPI
Lorena T Bonaventura, R.PH
- Pharmacist
- Somerville, MA
National Provider Identifier
1104145333
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 22059
- Practice address
- 393 Highland Ave
Somerville, MA 02144-2506 - Phone
- (617) 776-7730
- NPI assigned
- May 27, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 22059 | MA | Primary |
Addresses
Primary practice location
393 Highland Ave
Somerville, MA 02144-2506
Mailing address
393 Highland Ave
Somerville, MA 02144-2506
Phone (617) 776-7730
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22059 | MA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274918400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1405468800000",
"number": "1104145333",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "393 HIGHLAND AVE",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442506",
"telephone_number": "617-776-7730"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "393 HIGHLAND AVE",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442506",
"telephone_number": "617-776-7730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONAVENTURA",
"first_name": "LORENA",
"middle_name": "T",
"credential": "R.PH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-27",
"last_updated": "2014-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "22059",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.