Provider Demographics
NPI:1023614443
Name:KORONA, MICHELE ANNE
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:ANNE
Last Name:KORONA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01013-3433
Mailing Address - Country:US
Mailing Address - Phone:413-250-7012
Mailing Address - Fax:
Practice Address - Street 1:1282 SPRINGFIELD ST
Practice Address - Street 2:
Practice Address - City:FEEDING HILLS
Practice Address - State:MA
Practice Address - Zip Code:01030-2119
Practice Address - Country:US
Practice Address - Phone:413-789-2226
Practice Address - Fax:413-786-2422
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-10
Last Update Date:2020-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19565183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist