Justin J Bonacci, PT
Physical Therapist in Mastic, NY. Individual provider (NPI-1).
NPI number1700865136
StatusActive
Last updated in NPPESOct 31, 2017
Details
- NPI
- 1700865136
- Entity type
- Individual (NPI-1)
- Name
- Mr. Justin J Bonacci
- Credential
- PT
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 13, 2006
- Last updated
- Oct 31, 2017
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICAL THERAPIST IN PRIVATE PRACTICE
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 017345-1 | NY | Yes |
Practice location
1636 Montauk HwySte 4
Mastic, NY 11950-3016
Phone 631-399-0007 · Fax 631-399-2992
Mailing address
4 Quincy StPort Jefferson Station, NY 11776-3420
Phone 631-467-4235 · Fax 631-467-2655
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
Other Physical Therapist providers in Mastic, NY
Checking a whole list?
Paste a list of NPIs and get status, record, Medicare enrollment and OIG exclusion for each one. 100 free a day, then from $5 for 5,000. Useful for credentialing, billing and pharmacy claim checks.