Individual provider Active NPI

Julia Presti-Bonomo, DO

  • Family Medicine Physician
  • Middletown, DE
National Provider Identifier
1801874623
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
C20007106 Issued in DE
Practice address
124 Sleepy Hollow Dr
Suite 203
Middletown, DE 19709-8894
Phone
(302) 449-3030
Fax
(302) 449-3040
NPI assigned
Jan 3, 2006
Last updated
Nov 17, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X C20007106 DE Primary

Addresses

Primary practice location

124 Sleepy Hollow Dr
Suite 203
Middletown, DE 19709-8894

Mailing address

124 Sleepy Hollow Dr
Suite 203
Middletown, DE 19709-5838

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
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
C20007106DEMDFamily Medicine Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321488000000",
    "number": "1801874623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 SLEEPY HOLLOW DR",
            "address_2": "SUITE 203",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197095838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 SLEEPY HOLLOW DR",
            "address_2": "SUITE 203",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197098894",
            "telephone_number": "302-449-3030",
            "fax_number": "302-449-3040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTI-BONOMO",
        "first_name": "JULIA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2011-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C20007106",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.