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Jessica Bonilla
NPI 1043613516 · on the registry since 2014 · sole proprietor
Practice
- Address
- 156 Landing Meadow Rd
Smithtown, NY 11787 - Phone
- (631) 626-6377
- Clinicians at this address
- 2
Additional practice sites
- 4922 Lasalle Rd, Hyattsville, MD
Registry record
- Primary taxonomy
- 171400000X
171400000X
- Also registered as
- 235Z00000X
- Licence states on file
- MD
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2021-05-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York