Virginia Ann Bonoli, O.D.
Individual provider Active NPI Optometrist · Avon, MA
NPI 1508992967 · NPPES record last updated Apr 20, 2020
Key facts
- NPI
- 1508992967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 3404 (MA)
- Practice address
- 120 Stockwell Dr
Avon, MA 02322-1149 - Phone
- (508) 232-4012
- Fax
- (508) 232-4013
- NPI assigned
- Feb 27, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3404 | MA | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3404 | MA | Yes |
Addresses
Primary practice location
120 Stockwell Dr
Avon, MA 02322-1149
Mailing address
120 Stockwell Dr
Avon, MA 02322-1149
Phone (508) 837-3790
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5031433 | Other | MA | AETNA |
| W16552 | Other | MA | BC/BS |
Other providers in Avon, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 20, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.