Individual provider Active NPI

Marjorie Bonhomme, PHD

  • Clinical Laboratory Director (Non-physician)
  • Westbury, NY
National Provider Identifier
1841568524
Registry record updated Jul 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Laboratory Director (Non-physician)Taxonomy code 247ZC0005X
License
BONHM1 Issued in NY
Practice address
522 Alicia Dr
Westbury, NY 11590-1311
Phone
(502) 767-2420
NPI assigned
Dec 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Laboratory Director (Non-physician) 247ZC0005X DRH 102 CA
Clinical Laboratory Director (Non-physician) 247ZC0005X MTC 742 CA
Clinical Laboratory Director (Non-physician) 247ZC0005X BONHM1 NY Primary

Addresses

Primary practice location

522 Alicia Dr
Westbury, NY 11590-1311

Mailing address

400 Karin LN
Hicksville, NY 11801-5352
Phone (844) 522-8847

Other names 1

  • Dr. Marjorie Bonhomme Other name

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
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
DRH 102CAMDClinical Laboratory Director (Non-physician)
MTC 742CAMDClinical Laboratory Director (Non-physician)
BONHM1NYMDClinical Laboratory Director (Non-physician)

NPI Registry JSON

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

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1841568524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 KARIN LN",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118015352",
            "telephone_number": "844-522-8847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "522 ALICIA DR",
            "city": "WESTBURY",
            "state": "NY",
            "postal_code": "115901311",
            "telephone_number": "502-767-2420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONHOMME",
        "first_name": "MARJORIE",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-12-08",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "CA",
            "license": "DRH 102",
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "CA",
            "license": "MTC 742",
            "primary": false
        },
        {
            "code": "247ZC0005X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Clinical Laboratory Director, Non-physician",
            "state": "NY",
            "license": "BONHM1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJORIE",
            "last_name": "BONHOMME",
            "prefix": "DR.",
            "credential": "PHD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Westbury, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.