Adrienne Jade Bonanno, OTR/L, MS

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

020072 Issued in NY

Practice address

230 W Fulton St
Gloversville, NY 12078-2720

Phone

(518) 727-8220

NPI assigned

Nov 15, 2021

Last updated

Nov 15, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Miss Adrienne Jade Whelly Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1295491249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 QUEEN ANNE RD",
            "city": "AMSTERDAM",
            "state": "NY",
            "postal_code": "120108333",
            "telephone_number": "518-727-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W FULTON ST",
            "city": "GLOVERSVILLE",
            "state": "NY",
            "postal_code": "120782720",
            "telephone_number": "518-727-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONANNO",
        "first_name": "ADRIENNE",
        "middle_name": "JADE",
        "name_prefix": "Mrs.",
        "credential": "OTR/L, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "NY",
            "license": "020072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ADRIENNE",
            "last_name": "WHELLY",
            "middle_name": "JADE",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Sydney Raychele Bliss
• Gabriella M Blumberg
• Donald Bode
• Tina Bode, PHD, LMFT, PLLC
• Dunhill Joshua A Bollon, MSW
• Andrew Bornt
• Andrea Ann Bovee, MSW
• Deborah Jean Bovee, LCSW
• Sandra Lee Boyd, PA-C
• Bradley H Paddock MD

• Pediatric Occupational Therapist in Gloversville, NY
• Providers in Gloversville, NY by specialty
• Pediatric Occupational Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2021; 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.