Provider Demographics
NPI:1447544663
Name:BENONI, PAULA JEAN (RPH)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:JEAN
Last Name:BENONI
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 CHESHIRE RD
Mailing Address - Street 2:T-2127
Mailing Address - City:LANESBORO
Mailing Address - State:MA
Mailing Address - Zip Code:01237-9706
Mailing Address - Country:US
Mailing Address - Phone:413-236-4223
Mailing Address - Fax:413-236-4216
Practice Address - Street 1:655 CHESHIRE RD
Practice Address - Street 2:T-2127
Practice Address - City:LANESBORO
Practice Address - State:MA
Practice Address - Zip Code:01237-9706
Practice Address - Country:US
Practice Address - Phone:413-236-4223
Practice Address - Fax:413-236-4216
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22127183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist