Provider Demographics
NPI:1295094902
Name:BONDAR, RAQUEL (MS OTR/L)
Entity type:Individual
Prefix:
First Name:RAQUEL
Middle Name:
Last Name:BONDAR
Suffix:
Gender:F
Credentials:MS OTR/L
Other - Prefix:
Other - First Name:RAQUEL
Other - Middle Name:
Other - Last Name:HILLELSOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6412 ELRAY DR
Mailing Address - Street 2:APT C
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2936
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6412 ELRAY DR
Practice Address - Street 2:APT C
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2936
Practice Address - Country:US
Practice Address - Phone:917-974-7979
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-15
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017412225X00000X
MD06905225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist