Provider Demographics
NPI:1437193760
Name:BUONOCORE, DENISE M (APRN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:BUONOCORE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 MAIN ST
Mailing Address - Street 2:CARDIOVASCULAR MEDICINE DEPT
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-4201
Mailing Address - Country:US
Mailing Address - Phone:203-576-6167
Mailing Address - Fax:203-576-6146
Practice Address - Street 1:2800 MAIN ST
Practice Address - Street 2:CARDIOVASCULAR MEDICINE DEPT
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-4201
Practice Address - Country:US
Practice Address - Phone:203-576-6167
Practice Address - Fax:203-576-6146
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001097363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTS52589Medicare UPIN