Individual
NICHOLAS WILLIAM BONOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215-1161
(502) 361-6731
Mailing address
1850 BLUEGRASS AVE, LOUISVILLE, KY 40215-1161
(502) 361-6731
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
R5660
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
KY
Other
Enumeration date
05/24/2019
Last updated
06/19/2025
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