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NPI Code Detail

MEDICARE: MRS. DONNA ANGELA BONOMI MS/PT

MEDICARE: MRS. DONNA ANGELA BONOMI MS/PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251P0200XPediatric Physical Therapist020169NY
22251P0200XPediatric Physical Therapist

General Provider Information

NPI Number : 1083855613
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DONNA ANGELA BONOMI MS/PT
Provider Business Mailing Address
First Line : 7 MASON BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-1735
Country : US
Telephone Number : 718-619-3349
Fax Number :
Provider Business Practice Location Address
First Line : 7 MASON BLVD
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-1735
Country : US
Telephone Number : 718-619-3349
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2009
Last Update Date : 03/19/2012

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