Provider Demographics
NPI:1922738004
Name:BUNDU, ABDUL (LBS)
Entity Type:Individual
Prefix:MR
First Name:ABDUL
Middle Name:
Last Name:BUNDU
Suffix:
Gender:M
Credentials:LBS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 N PARK RD STE 2
Mailing Address - Street 2:
Mailing Address - City:WYOMISSING
Mailing Address - State:PA
Mailing Address - Zip Code:19610-2941
Mailing Address - Country:US
Mailing Address - Phone:484-516-2330
Mailing Address - Fax:
Practice Address - Street 1:390 E MAIN ST
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-2580
Practice Address - Country:US
Practice Address - Phone:717-466-6505
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst