MEDICARE: CAILYN BONGIORNO

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
1	225100000X	Physical Therapist	5501303521	MI

General Provider Information

NPI Number	:	1487487682
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAILYN BONGIORNO

Provider Business Mailing Address
First Line	:	5340 PLAZA AVE STE 3
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-1446
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5340 PLAZA AVE STE 3
Second Line	:
City	:	HUDSONVILLE
State	:	MI
Zip	:	49426-1446
Country	:	US
Telephone Number	:	616-608-8922
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	12/10/2025

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Directions to “ CAILYN BONGIORNO ” Practice Location

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