Individual
DAISY ROSADO-BUNKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2412 CHURCH AVE, BROOKLYN, NY 11226
(855) 681-8700
Mailing address
975 OCEAN AVE, BROOKLYN, NY 11226-6759
(347) 210-1473
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00355940
AGENCY MEDICAID
—
01
—
1285628552
AGENCY NPI
NY
01
—
WVE061
AGENCY MEDICARE
—
Enumeration date
11/12/2012
Last updated
07/06/2018
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