Provider Demographics
NPI:1124561576
Name:MENDELOWITZ STEINHOLZ, BONNIE FERN
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:FERN
Last Name:MENDELOWITZ STEINHOLZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3329 BAYFIELD BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-4621
Mailing Address - Country:US
Mailing Address - Phone:516-764-7398
Mailing Address - Fax:
Practice Address - Street 1:6302 AVENUE U
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5906
Practice Address - Country:US
Practice Address - Phone:718-241-1086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003797235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist