OMAWATIE SHELLY GOPEE-BONILLA MSN RN FNP-BC NPI 1700421336

NPI Information

NPI: 1700421336
Provider Name: OMAWATIE SHELLY GOPEE-BONILLA, MSN, RN, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
1775 GRAND CONCOURSE FL 5
BRONX, NY
ZIP 10453
Phone: (561) 472-4701
Get Directions

Omawatie Shelly Gopee-bonilla, MSN, RN, FNP-BC is a family nurse practitioner in Bronx, NY. Omawatie Shelly Gopee-bonilla, MSN, RN, FNP-BC NPI is 1700421336. The provider is registered as an individual entity type and is a multi-specialty group.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1775 GRAND CONCOURSE FL 5
BRONX, NY
ZIP 10453-202
Phone: (561) 472-4701

The NPI 1700421336 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/7/2019 and was last updated on 11/27/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	F345067-01	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	F345067-01	OTHER	NEW YORK	NEW YORK STATE OFFICE OF THE PROFESSIONS
2	2019039937	OTHER	MARYLAND	AMERICAN NURSES CREDENTIALING CENTER

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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