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General NPI Number Information
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NPI Number | 1902383458
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Entity Type | Individual
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Provider Name | BIANCA GONDEK MSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/26/2018
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Provider Practice Location Address
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Address Line | 114-152 BOSTON POST RD #2
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City | WEST HAVEN
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State | CT
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Zip | 06516
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Country | US
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Telephone | 203-479-8000
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Fax |
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Provider Business Mailing Address
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Address Line | 36 SHARON DR
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City | EAST HAVEN
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State | CT
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Zip | 06512-1519
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Country | US
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Telephone | 203-654-5679
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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 |
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License Number State |
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