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General NPI Number Information
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NPI Number | 1760898779
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Entity Type | Individual
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Provider Name | MARIA BONCYK LCSW
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Gender | Female
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Dates
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Enumeration Date | 07/10/2014
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 546 EASTERN PKWY
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City | BROOKLYN
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State | NY
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Zip | 11225-1604
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Country | US
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Telephone | 917-905-1745
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Fax |
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Provider Business Mailing Address
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Address Line | 415 BEVERLEY RD APT 2J
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City | BROOKLYN
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State | NY
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Zip | 11218-3127
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Country | US
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Telephone | 608-206-7222
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 0903001891
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 091865-1
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License Number State | NY
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