Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MICHAEL THOMAS BONACUSO, ATC
Active Sole ProprietorMICHAEL THOMAS BONACUSO, ATC is a Athletic Trainer healthcare provider located in EAST WILLISTON, New York. NPI 1245728013 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · EAST WILLISTON, NY
Registration Details
- NPI Number
- 1245728013
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 27, 2018 (8.2573492232948 yrs)
- Last Updated
- Apr 27, 2018
- Sole Proprietor
- Yes
Practice Information
- Address
-
15 SHADOW LNEAST WILLISTON, NY, 115962510Browse NY providers · Browse ZIP 11596
- Phone
- 5163844354
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.