Bonnie Anne Nezlick

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

40QA00624200 Issued in NJ

Practice address

550 Central Ave
New Providence, NJ 07974-1505

Phone

(908) 522-2215

Fax

(908) 522-0764

NPI assigned

Apr 1, 2020

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ahs Hospital Corp

  • Clinical Medical Laboratory
  • Morristown, NJ
  • NPI 1871162834
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1164050233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 CENTRAL AVE",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741505",
            "telephone_number": "908-522-2215",
            "fax_number": "908-522-0764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 CENTRAL AVE",
            "city": "NEW PROVIDENCE",
            "state": "NJ",
            "postal_code": "079741505",
            "telephone_number": "908-522-2215",
            "fax_number": "908-522-0764"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEZLICK",
        "first_name": "BONNIE",
        "middle_name": "ANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NJ",
            "license": "41YS00928700",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NJ",
            "license": "40QA00624200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• New Jersey Organ & Tissue Sharing Network
• New Providence Dentistry LLC
• New Providence Family Practice Corporation
• New Providence Internal Medicine Associates
• New Providence Orthodontics LLC
• Karolina Nicewicz, PSY.D.
• Jezabel Mariela Novo-Frias, APN
• Lauriann O'Brien, LCSW
• Astrude D Octavius-Zamor, MASTERS, DOCTORATE
• Michael John Orlando, D.C.

• Physical Therapist in New Providence, NJ
• Providers in New Providence, NJ by specialty
• Physical Therapist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.