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Lisa E Bonner, RPh

Pharmacist in Watertown, NY. Individual provider (NPI-1).

NPI number1053633503
StatusActive
Last updated in NPPESFeb 25, 2010

Details

NPI
1053633503
Entity type
Individual (NPI-1)
Name
Mrs. Lisa E Bonner
Credential
RPh
Sex
Female
Sole proprietor
No
Enumeration date
Feb 25, 2010
Last updated
Feb 25, 2010

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
Can order and refer
Not on the CMS order and referring list
OIG exclusion list
This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
183500000X Pharmacist33277NYYes

Practice location

929 Arsenal St
Watertown, NY 13601-2305

Phone 315-788-0309 · Fax 315-788-1702

Mailing address

929 Arsenal St
Watertown, NY 13601

Phone 315-788-0309 · Fax 315-788-1702

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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