Provider Demographics
NPI:1487218657
Name:BONNELL, ERICA
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:BONNELL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:141 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-1667
Mailing Address - Country:US
Mailing Address - Phone:603-659-2015
Mailing Address - Fax:
Practice Address - Street 1:180 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-1311
Practice Address - Country:US
Practice Address - Phone:603-335-6666
Practice Address - Fax:603-335-1435
Is Sole Proprietor?:No
Enumeration Date:2019-04-23
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NH0996152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program