Healthcare Provider Details

I. General information

NPI: 1689761199
Provider Name (Legal Business Name): JESSICA BONDI LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WESTCHESTER SQ
BRONX NY
10461-3525
US

IV. Provider business mailing address

189 E 93RD ST 4B
NEW YORK NY
10128-3751
US

V. Phone/Fax

Practice location:
  • Phone: 718-931-4045
  • Fax: 718-828-1329
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number070502
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: