Provider Demographics
NPI:1083810519
Name:BONET, DUJARDIN (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:DUJARDIN
Middle Name:
Last Name:BONET
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 FLEET CT
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10473-2454
Mailing Address - Country:US
Mailing Address - Phone:917-817-4422
Mailing Address - Fax:
Practice Address - Street 1:107 FLEET CT
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10473-2454
Practice Address - Country:US
Practice Address - Phone:917-817-4422
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0606131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical