Yvette Bonilla
Individual provider Active NPI Physical Therapy Assistant · Pawtucket, RI
NPI 1508308883 · NPPES record last updated Nov 17, 2016
Key facts
- NPI
- 1508308883
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 8631 (MA)
- Practice address
- 111 Central Ave
Apt 1
Pawtucket, RI 02860-1310 - Phone
- (401) 632-5895
- NPI assigned
- Nov 17, 2016
- 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 |
|---|---|---|---|
| 8631 | MA | MD | Physical Therapy Assistant |
| PTA00855 | RI | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 8631 | MA | Yes |
| Physical Therapy Assistant | 225200000X | PTA00855 | RI |
Addresses
Primary practice location
111 Central Ave
Apt 1
Pawtucket, RI 02860-1310
Mailing address
111 Central Ave
Apt 1
Pawtucket, RI 02860-1310
Phone (401) 632-5895
Other providers in Pawtucket, RI
- Margarita Laporte Bomfim Bockorny
- Irina M Boguk
- Nicholle Boisclair
- Heather Allison Bonds-Harmon
- Lynne Bongette
- Dinora Borges
- Jeffrey M Borkan
- Elisabeth Gessie Borno
- Dawn M Borschel
- Erin R Botelho
All providers in Pawtucket, RI · Physical Therapy Assistant in Rhode Island
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 17, 2016. 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.