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Nicole Bonelli, Lpn

Licensed Practical Nurse in Island Park, NY. Individual provider (NPI-1).

NPI number1902452170
StatusActive
Last updated in NPPESAug 14, 2019

Details

NPI
1902452170
Entity type
Individual (NPI-1)
Name
Nicole Bonelli
Credential
Lpn
Sex
Female
Sole proprietor
Yes
Enumeration date
Aug 14, 2019
Last updated
Aug 14, 2019

Medicare and OIG

Medicare enrolled (PECOS)
Not in the Medicare enrollment file
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 codeDescriptionLicenseStatePrimary
164W00000X Licensed Practical Nurse333205NYYes

Practice location

99 Waterford Rd
Island Park, NY 11558-1023

Phone 516-974-5742

Mailing address

99 Waterford Rd
Island Park, NY 11558-1023

Phone 516-974-5742

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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.

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