Rosemary Bonilla – Speech-Language Pathologist

Key facts

NPI: 1497976336
Entity type: Individual (NPI type 1)
Primary specialty: Speech-Language Pathologist 235Z00000X
License: 003773 (CT)
Practice address: 60 Connolly Pkwy
Hamden, CT 06514-2593
Phone: (203) 230-2815
Fax: (203) 230-8502
NPI assigned: May 1, 2007
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
Credentials: Master of Science

State licenses

License	State	Type	Specialty
003773	CT	MD	Speech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Speech-Language Pathologist	235Z00000X	003773	CT	Yes

Addresses

Primary practice location

60 Connolly Pkwy
Hamden, CT 06514-2593

Mailing address

60 Connolly Pkwy
Hamden, CT 06514-2593
Phone (203) 230-2815

Other identifiers

Identifier	Type	State	Issuer
003773	Other	CT	STATE LICENSE

Other names

Rosemary Coffy Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1177977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497976336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 CONNOLLY PKWY",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142593",
            "telephone_number": "203-230-2815",
            "fax_number": "203-230-8502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 CONNOLLY PKWY",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065142593",
            "telephone_number": "203-230-2815",
            "fax_number": "203-230-8502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "ROSEMARY",
        "credential": "MS, CCC SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003773",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "003773",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROSEMARY",
            "last_name": "COFFY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hamden, CT

All providers in Hamden, CT · Speech-Language Pathologist in Connecticut

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. 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.

Verify at the official NPI Registry.