| Organization Name: | CHARTWELL SOUTHERN NEW ENGLAND, LLC |
| NPI Number: | 1790725588 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JOSEPH BONACCORSI (MANAGING MEMBER) |
| Mailing Address: | 80 Clark Dr Unite 1-a East Berlin |
| State: | CT US |
| Postal Code: | 060231157 |
| Phone Number: | 8007551511 |
| Fax Number: | 8608280029 |
| NPI Enumeration Date: | 06/08/2006 |
| NPI Last Update Date: | 01/19/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 332BP3500X |
| License Number: | 1385 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CT |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
| Taxonomy Specialization: | Parenteral & Enteral Nutrition |
| Taxonomy Definition: | |