Active NPI
Pamela Bonney, MS, RD, CDN
- Registered Dietitian
- Huntington, NY
National Provider Identifier
1760690457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 005023-1
- Practice address
- 75 Prospect St
Suite LL3
Huntington, NY 11743-3382 - Phone
- (646) 389-0480
- NPI assigned
- May 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Education Nutritionist | 133NN1002X | 005023-1 | NY | |
| Registered Dietitian | 133V00000X | 005023-1 | NY | Primary |
| Pediatric Nutrition Registered Dietitian | 133VN1004X | 005023-1 | NY | |
| Nutritionist | 133N00000X | 005023-1 | NY | |
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 005023-1 | NY |
Addresses
Primary practice location
75 Prospect St
Suite LL3
Huntington, NY 11743-3382
Mailing address
86 Kenneth Ave
Huntington, NY 11743-4929
Phone (646) 389-0480
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
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005023-1 | NY | MD | Occupational Therapist |
| 005023 | NY | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179446400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1464652800000",
"number": "1760690457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 KENNETH AVE",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117434929",
"telephone_number": "646-389-0480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 PROSPECT ST",
"address_2": "SUITE LL3",
"city": "HUNTINGTON",
"state": "NY",
"postal_code": "117433382",
"telephone_number": "646-389-0480"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNEY",
"first_name": "PAMELA",
"credential": "MS, RD, CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-18",
"last_updated": "2016-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "133NN1002X",
"taxonomy_group": "",
"desc": "Nutritionist, Nutrition, Education",
"state": "NY",
"license": "005023-1",
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "005023-1",
"primary": true
},
{
"code": "133VN1004X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Pediatric",
"state": "NY",
"license": "005023-1",
"primary": false
},
{
"code": "133N00000X",
"taxonomy_group": "",
"desc": "Nutritionist",
"state": "NY",
"license": "005023-1",
"primary": false
},
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": "NY",
"license": "005023-1",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Huntington, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.