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General NPI Number Information
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NPI Number | 1548382799
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Entity Type | Individual
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Provider Name | LORI ELIZABETH ABONDOLO LCSW
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Gender | Female
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2324 FOREST AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10303-1506
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Country | US
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Telephone | 718-447-0200
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Fax | 718-981-1431
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Provider Business Mailing Address
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Address Line | 115 HAMPTON PL
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City | STATEN ISLAND
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State | NY
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Zip | 10309-1671
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Country | US
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Telephone | 347-866-1449
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Fax | 718-667-2522
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 070755-1
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License Number State | NY
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