Active NPI
Jose Miguel Bonifacio
- Clinical Social Worker
- New York, NY
National Provider Identifier
1710199518
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 048570
- Practice address
- 651 Academy St
New York, NY 10034-5003 - Phone
- (212) 942-0043
- NPI assigned
- May 4, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 048570 | NY | Primary |
Addresses
Primary practice location
651 Academy St
New York, NY 10034-5003
Mailing address
2254 Cedar Avenue # 1a
Bronx, NY 10468
Phone (212) 942-0043
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 048570 | NY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1710199518",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2254 CEDAR AVENUE # 1A",
"city": "BRONX",
"state": "NY",
"postal_code": "10468",
"telephone_number": "212-942-0043"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "651 ACADEMY ST",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100345003",
"telephone_number": "212-942-0043"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONIFACIO",
"first_name": "JOSE",
"middle_name": "MIGUEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "048570",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.