Michael Boniello, M.D., M.Sc.
Orthopaedic Surgery, Sports Medicine in Rocky Hill, CT. Individual provider (NPI-1).
NPI number1023469293
StatusActive
Last updated in NPPESMay 15, 2023
Details
- NPI
- 1023469293
- Entity type
- Individual (NPI-1)
- Name
- Michael Boniello
- Credential
- M.D., M.Sc.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 28, 2016
- Certification date
- May 15, 2023
- Last updated
- May 15, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207XX0005X | Orthopaedic Surgery, Sports Medicine | 70647 | CT | Yes |
| 207X00000X | Orthopaedic Surgery | 70647 | CT |
Practice location
1111 Cromwell Ave Ste 404Rocky Hill, CT 06067-3455
Phone 860-525-4469
Mailing address
1111 Cromwell Ave Ste 404Rocky Hill, CT 06067-3455
Phone 860-525-4469
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