Individual
DR. MICHAEL BONOMO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
24302 NORTHERN BLVD, DOUGLASTON, NY 11362-1150
(718) 423-6200
Mailing address
22 BOB-O-LINK LANE, NORTHPORT, NY 11768-3305
(917) 837-5922
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
021438
NY
Other
Enumeration date
09/08/2014
Last updated
11/26/2025
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