Active NPI
Nefretiri Bonomo, MS, OTR/L
- Occupational Therapist
- Valhalla, NY
National Provider Identifier
1720220114
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 015623-1
- Practice address
- 503 Grasslands Rd
Valhalla, NY 10595-1503 - Phone
- (914) 593-0593
- Fax
- (914) 593-0594
- NPI assigned
- Mar 31, 2009
- 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 | 015623-1 | NY | Primary |
Addresses
Primary practice location
503 Grasslands Rd
Valhalla, NY 10595-1503
Mailing address
274 Hooker Ave
Apt. M2
Poughkeepsie, NY 12603-3035
Phone (845) 452-5260
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 015623-1 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1238457600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1238457600000",
"number": "1720220114",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "274 HOOKER AVE",
"address_2": "APT. M2",
"city": "POUGHKEEPSIE",
"state": "NY",
"postal_code": "126033035",
"telephone_number": "845-452-5260"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "503 GRASSLANDS RD",
"city": "VALHALLA",
"state": "NY",
"postal_code": "105951503",
"telephone_number": "914-593-0593",
"fax_number": "914-593-0594"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONOMO",
"first_name": "NEFRETIRI",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-03-31",
"last_updated": "2009-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NY",
"license": "015623-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valhalla, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.