Yvette Bonilla
Individual provider Active NPI Speech-Language Pathologist · Atlantic Beach, NY
NPI 1376775601 · NPPES record last updated Aug 20, 2009
Key facts
- NPI
- 1376775601
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Speech-Language Pathologist 235Z00000X
- License
- 019429-1 (NY)
- Practice address
- 1524 Beech St
Atlantic Beach, NY 11509-1636 - Phone
- (408) 355-5790
- NPI assigned
- Aug 20, 2009
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019429-1 | NY | MD | Occupational Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 019429-1 | NY | Yes |
Addresses
Primary practice location
1524 Beech St
Atlantic Beach, NY 11509-1636
Mailing address
1524 Beech St
Atlantic Beach, NY 11509-1636
Phone (408) 355-5790
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- Helen Bloomer
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- Lisa Marie Butera-Sgouros
- Nicole Buttafuoco
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All providers in Atlantic Beach, NY · Speech-Language Pathologist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.