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Individual
MS. KATHY BONANNO
Active
Individual
MS. KATHY BONANNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X005300-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
X005300-1
REGISTRATION CERTIFICATE
NY
Enumeration date
10/12/2011
Last updated
02/07/2014
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