Active NPI
Jillian Bonner, M. ED., BCBA
- Behavior Analyst
- Hauppauge, NY
National Provider Identifier
1962805796
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Behavior Analyst
- Practice address
- 759 Village Dr
Hauppauge, NY 11788-3214 - Phone
- (631) 839-7136
- NPI assigned
- Oct 7, 2014
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Behavior Analyst | 103K00000X | Primary |
Addresses
Primary practice location
759 Village Dr
Hauppauge, NY 11788-3214
Mailing address
759 Village Dr
Hauppauge, NY 11788-3214
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
- Master of Education
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1412640000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1412640000000",
"number": "1962805796",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "759 VILLAGE DR",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117883214"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "759 VILLAGE DR",
"city": "HAUPPAUGE",
"state": "NY",
"postal_code": "117883214",
"telephone_number": "631-839-7136"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONNER",
"first_name": "JILLIAN",
"credential": "M. ED., BCBA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-10-07",
"last_updated": "2014-10-07",
"status": "A"
},
"taxonomies": [
{
"code": "103K00000X",
"taxonomy_group": "",
"desc": "Behavior Analyst",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hauppauge, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.