Laurie Ann Bonomo, LMSW
Individual provider Active NPI Social Worker · Oakdale, NY
NPI 1962297093 · NPPES record last updated Jun 5, 2025
Key facts
- NPI
- 1962297093
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- 125112 (NY)
- Practice address
- 405 Locust Ave
Oakdale, NY 11769-1651 - Phone
- (631) 240-8009
- NPI assigned
- Apr 10, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125112 | NY | MD | Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 125112 | NY | Yes |
Addresses
Primary practice location
405 Locust Ave
Oakdale, NY 11769-1651
Mailing address
405 Locust Ave
Oakdale, NY 11769-1651
Phone (631) 240-8009
Other providers in Oakdale, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.