Healthcare Provider Details

I. General information

NPI: 1780891127
Provider Name (Legal Business Name): BONNIE ZINDEL LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 W 57TH ST SUITE 501
NEW YORK NY
10107-0001
US

IV. Provider business mailing address

250 W 57TH ST SUITE 501
NEW YORK NY
10107-0001
US

V. Phone/Fax

Practice location:
  • Phone: 212-265-2462
  • Fax: 212-877-2149
Mailing address:
  • Phone: 212-265-2462
  • Fax: 212-877-2149

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License NumberSWL 315 2719
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: