Provider Demographics
NPI:1740753961
Name:POLLAK, BONNIE (JD, LMSW)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:
Last Name:POLLAK
Suffix:
Gender:F
Credentials:JD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1175 PARK AVE # 6C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1211
Mailing Address - Country:US
Mailing Address - Phone:917-453-8477
Mailing Address - Fax:
Practice Address - Street 1:850 7TH AVE # 6C
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5230
Practice Address - Country:US
Practice Address - Phone:917-453-8477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-10
Last Update Date:2019-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker