Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clarissa Ann Bonanno, MD

Individual provider Obstetrics & Gynecology Physician · NPI 1164673349

Clarissa Ann Bonanno, MD is an Obstetrics/Gynecology in New Hyde Park, New York. Graduated from Columbia University College of Physicians and Surgeons in 2002, 24 years ago. Practices with North Shore-Lij Medical PC, a 6,350-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
24
Trained at
Columbia University College of Physicians and Surgeons
Licensed in
NY
In the registry since
2008
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1111 Marcus Ave Ste M10C
New Hyde Park, NY 11042-2036
Phone: (212) 266-3500
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Maternal & Fetal Medicine Physician (primary) Taxonomy 207VM0101X · Licence 236458 (NY)
Obstetrics & Gynecology Physician Taxonomy 207V00000X · Licence 236458 (NY)

Record details

NPI number1164673349
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 6, 2008
Last updated in NPPESSeptember 6, 2023
Certification dateSeptember 6, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolCOLUMBIA UNIVERSITY COLLEGE OF PHYSICIANS AND SURGEONS
Graduated 2002 (24 years in practice)
Group practice North Shore-Lij Medical Pc — 6350 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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