IndividualActive
Lizzette Bonilla, MASTERS PLUS 30
NPI 1700508496 · Specialist · Deer Park, NY
Lizzette Bonilla, MASTERS PLUS 30 is a Specialist provider in Deer Park, NY (NPI 1700508496).
Provider details
- NPI number
- 1700508496
- Entity type
- Individual
- Primary specialty
- SpecialistOther Service Providers
- Credential
- MASTERS PLUS 30
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Profile Score
Established profile(53/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
3 yrs in NPPES registry
- Profile completeness38% of score
83% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1014 Grand Blvd Ste 5
Deer Park, NY 11729-5782
Phone: (631) 243-1765
Street-level locationGet directions
Mailing address
30 Saint Andrews Dr
Brentwood, NY 11717-1026
Registry dates
- Enumerated
- 2022-09-19
- Last updated
- 2022-09-19
- Certified
- 2022-09-16
Frequently asked questions
- What is Lizzette Bonilla's NPI number?
- Lizzette Bonilla's National Provider Identifier (NPI) is 1700508496, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Lizzette Bonilla's specialty?
- Lizzette Bonilla is listed in the NPPES registry with a primary specialty of Specialist (Other Service Providers).
- Where is Lizzette Bonilla located?
- Lizzette Bonilla's practice location on file with NPPES is 1014 Grand Blvd Ste 5, Deer Park, NY 11729-5782.
- What is Lizzette Bonilla's phone number?
- The practice phone number listed in the NPPES registry for Lizzette Bonilla is (631) 243-1765.
- Is Lizzette Bonilla's NPI active?
- Yes — Lizzette Bonilla's NPI (1700508496) is active in the NPPES registry as of the last update on 2022-09-19.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.