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Individual
MICHAEL BONANNI
Active
Individual
MICHAEL BONANNI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
040779
NY
2251G0304X
Geriatric Physical Therapist
040779
NY
Other
Enumeration date
09/02/2018
Last updated
11/21/2019
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