Most Relevant Information
Provider Data
| NPI Number: | 1003413394 |
| Provider Name: | JONATHAN CHARLES BANNIGAN MHC-LP |
| Entity Type: | Individual |
| Taxonomy Code: | 101YM0800X |
| Specialty: | Counselor |
| License Number: | P107008 |
Most Important Dates
| Enumeration Date: | 10/08/2020 |
| Last Updated: | 10/08/2020 |
Provider Practice Location
260 MADISON AVE FL 8
NEW YORK
NY
100162418
Practice Location Phone/Fax
| Phone: | 2123350511 |
| Fax: |
Provider Mailing Location
176 GLENWOOD AVE APT 2R
BLOOMFIELD
NJ
070032346
Provider Mailing Phone/Fax
| Phone: | 3153350934 |
| Fax: |