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

LicenseStateTypeSpecialty
019429-1NYMDOccupational Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
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

Other providers in Atlantic Beach, NY

All providers in Atlantic Beach, NY · Speech-Language Pathologist in New York

Sources for this page

Verify at the official NPI Registry.