Individual
KELLI-ANNE BONOMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
104 MAJESTIC DR, DIX HILLS, NY 11746-4935
(631) 499-5404
Mailing address
41 MCKINNEY AVE, NORTHPORT, NY 11768-1808
(631) 827-4337
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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