Provider Demographics
NPI:1780891127
Name:ZINDEL, BONNIE (LCSW)
Entity type:Individual
Prefix:MS
First Name:BONNIE
Middle Name:
Last Name:ZINDEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 W 57TH ST
Mailing Address - Street 2:SUITE 501
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10107-0001
Mailing Address - Country:US
Mailing Address - Phone:212-265-2462
Mailing Address - Fax:212-877-2149
Practice Address - Street 1:250 W 57TH ST
Practice Address - Street 2:SUITE 501
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10107-0001
Practice Address - Country:US
Practice Address - Phone:212-265-2462
Practice Address - Fax:212-877-2149
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYSWL 315 2719102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2Z921Medicare UPIN
NYN2Z921Medicare ID - Type Unspecified