Provider Demographics
NPI:1972880367
Name:BONDI, JEAN MARIE (MA CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:JEAN MARIE
Middle Name:
Last Name:BONDI
Suffix:
Gender:F
Credentials:MA CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2038 DECKER AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-2122
Mailing Address - Country:US
Mailing Address - Phone:516-379-0067
Mailing Address - Fax:
Practice Address - Street 1:2038 DECKER AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2122
Practice Address - Country:US
Practice Address - Phone:516-379-0067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-14
Last Update Date:2011-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010516235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist