Individual
AMANDA BONO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 ROUTE 111, SMITHTOWN, NY 11787-3754
(631) 920-8300
Mailing address
14202 20TH AVE FL 3, FLUSHING, NY 11351-3000
(917) 563-3350
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
744111979-00
—
NY
Enumeration date
07/13/2017
Last updated
12/30/2020
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