DR. EDWARD JOHN BONAVILLA (NPI# 1629030960) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629030960 |
| Entity Type | Individual |
| Full Name | DR. EDWARD JOHN BONAVILLA |
| Credential | DPM |
| Practice Address |
490 Titus Ave Rochester NY 14617-3541 |
| Practice Telephone | 5855443620 |
| Practice Fax Number | 5855444567 |
| Mailing Telephone | 5855443620 |
| Mailing Fax Number | 5855444567 |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
002178 | NY | Podiatric Medicine & Surgery Service Providers |
| Street Address |
490 TITUS AVE |
| City | ROCHESTER |
| State | NY |
| Zip Code | 14617-3541 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386606630 | Joseph Larry Carbone | Podiatrist | 490 Titus Ave, Rochester, NY 14617-3541 | 2006-04-03 |
| 1790850436 | Rochester Foot Care Associates LLP | Podiatrist | 490 Titus Ave, Rochester, NY 14617-3541 | 2006-11-21 |
| 1114989464 | David Vigdor Chazan | Podiatrist | 490 Titus Ave, Rochester, NY 14617-3541 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720625148 | Taylor Barrett | Speech-Language Pathologist | 350 Cooper Road, Rochester, NY 14617 | 2019-12-04 |
| 1326517608 | Matthew Richard Vandermeid | Student in an Organized Health Care Education/Training Program | 161 Sethland Dr., Rochester, NY 14617 | 2018-11-16 |
| 1174031652 | Joseph Tshamala | Chiropractor | 2164 Hudson Ave., Rochester, NY 14617 | 2018-01-18 |
| 1043585599 | Shannon Nichole Fridd | Speech-Language Pathologist | 350 Cooper Rd., Rochester, NY 14617 | 2012-03-16 |
| 1861777112 | Todd M Schoen | Pharmacist | 525 Titus Avenue, Rochester, NY 14617 | 2011-10-19 |
| 1225317266 | Easter Seals New York, Inc. | Intermediate Care Facility, Mental Illness | 304 Daley Blvd, Rochester, NY 14617 | 2011-08-09 |
| 1407135445 | Easter Seals New York, Inc. | Intermediate Care Facility, Mental Illness | 404 Rogers Pkwy, Rochester, NY 14617 | 2011-08-09 |
| 1316226350 | Easter Seals of Ny, Inc | Intermediate Care Facility, Mental Illness | 302 Daley Boulevard, Rochester, NY 14617 | 2011-08-09 |
| 1215225602 | Alberto Ramon Cebollero | Psychologist | 402 Rogers Parkway, The Kessler Center, Rochester, NY 14617 | 2011-07-19 |
| 1487893269 | Stepping Stones Learning Center | Early Intervention Provider Agency | 2111 Hudson Ave, Rochester, NY 14617 | 2009-02-18 |
| Find all providers in zip 14617 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023538493 | Foot and Ankle Clinic | Podiatrist | 2768 Superior Dr Nw Ste B, Rochester, MN 55901-8394 | 2017-06-26 |
| 1346603701 | Laura M Buehler | Podiatrist | 2768 Superior Dr Nw, Rochester, MN 55901-3063 | 2016-04-03 |
| 1770710683 | Katrina Jeanne Manos | Podiatrist | 2236 Ridge Rd W., Rochester, NY 14626-2804 | 2009-06-18 |
| 1336272517 | Stephen Edward Panetta | Podiatrist | 2768 Superior Drive Nw, Rochester, MN 55901 | 2007-03-14 |
| 1518054485 | Metro Footcare Associates L.l.p. | Podiatrist | 2225 Clinton Ave S, Rochester, NY 14618-2623 | 2006-10-10 |
| 1053417014 | Genesee Valley Podiatry LLP | Podiatrist | 500 W Whitney Road, Rochester, NY 14621-3064 | 2006-09-16 |
| 1942243993 | Kevin D Lind | Podiatrist | 210 9th St Se Ste 1, Rochester, MN 55904-6400 | 2006-06-14 |
| 1598718017 | Massimo Pietrantoni | Podiatrist | 382 White Spruce Blvd, Rochester, NY 14623-1604 | 2006-05-18 |
| 1902863863 | Louis J Tallo | Podiatrist | 2225 S Clinton Ave, Rochester, NY 14618-2623 | 2006-04-26 |
| 1386606630 | Joseph Larry Carbone | Podiatrist | 490 Titus Ave, Rochester, NY 14617-3541 | 2006-04-03 |
| Find all providers in ROCHESTER | ||||
Please comment or provide details below to improve the information on DR. EDWARD JOHN BONAVILLA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.