Active NPI
Bonnie J Wolniak
- Pediatric Skilled Nursing Facility
- Liverpool, NY
National Provider Identifier
1790980803
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Skilled Nursing Facility
- License
- 407331-1
- Legal business name
- BONNIE J WOLNIAK
- Practice address
- 7 Tree Line Dr
Liverpool, NY 13090-3032 - Phone
- (315) 622-4055
- NPI assigned
- Jun 19, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Bonnie Wolniak
- Title
- Registered Nurse
- Phone
- (315) 622-4055
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Skilled Nursing Facility | 3140N1450X | 407331-1 | NY | Primary |
Addresses
Primary practice location
7 Tree Line Dr
Liverpool, NY 13090-3032
Mailing address
7 Tree Line Dr
Liverpool, NY 13090-3032
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01449889 | Medicaid | NY |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1182211200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1213315200000",
"number": "1790980803",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 TREE LINE DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903032"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 TREE LINE DR",
"city": "LIVERPOOL",
"state": "NY",
"postal_code": "130903032",
"telephone_number": "315-622-4055"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "BONNIE J WOLNIAK",
"organizational_subpart": "NO",
"enumeration_date": "2007-06-19",
"last_updated": "2008-06-13",
"status": "A",
"authorized_official_last_name": "WOLNIAK",
"authorized_official_first_name": "BONNIE",
"authorized_official_title_or_position": "REGISTERED NURSE",
"authorized_official_telephone_number": "315-622-4055",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "3140N1450X",
"taxonomy_group": "",
"desc": "Skilled Nursing Facility, Nursing Care, Pediatric",
"state": "NY",
"license": "407331-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01449889",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Liverpool, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.