Active NPI
Tracey Bonafede
- Occupational Therapist
- Williamsville, NY
National Provider Identifier
1497077762
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 10331
- Practice address
- 8307 Kimberly Rd
Williamsville, NY 14221-6168 - Phone
- (336) 409-5555
- NPI assigned
- Feb 26, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 10331 | CA | Primary |
Addresses
Primary practice location
8307 Kimberly Rd
Williamsville, NY 14221-6168
Mailing address
8307 Kimberly Rd
Williamsville, NY 14221-6168
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10331 | CA | MD | Pharmacist |
| 008944 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1267142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1267142400000",
"number": "1497077762",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8307 KIMBERLY RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142216168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8307 KIMBERLY RD",
"city": "WILLIAMSVILLE",
"state": "NY",
"postal_code": "142216168",
"telephone_number": "336-409-5555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONAFEDE",
"first_name": "TRACEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-02-26",
"last_updated": "2010-02-26",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "CA",
"license": "10331",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Williamsville, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.