National Provider Identifier
Edward John Bonavilla, DPM
Edward John Bonavilla, DPM is listed in the NPPES registry with a primary specialty of Foot & Ankle Surgery Podiatrist in Rochester, NY and a listed phone number of (585) 544-3620.
Profile Overview
- NPI
- 1629030960
- Provider Type
- Individual
- Primary Specialty
- Foot & Ankle Surgery Podiatrist
- Enumeration Date
- April 03, 2006
- Last Updated
- July 08, 2007
Practice Location
- 490 Titus Ave
- Rochester, NY 14617-3541
Phone: (585) 544-3620
Specialties
- Foot & Ankle Surgery Podiatrist (213ES0103X)
Full Record
- NPI
- 1629030960
- Entity Type
- Individual
- Last Name
- Bonavilla
- First Name
- Edward
- Middle Name
- John
- Name Prefix
- Dr.
- Credential
- DPM
- Mailing Street Address
- 490 Titus Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14617-3541
- Mailing Country
- US
- Mailing Phone
- (585) 544-3620
- Mailing Fax
- (585) 544-4567
- Practice Street Address
- 490 Titus Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14617-3541
- Practice Country
- US
- Practice Phone
- (585) 544-3620
- Practice Fax
- (585) 544-4567
- Enumeration Date
- April 03, 2006
- Last Updated
- July 08, 2007
- Sex
- Male
- Sole Proprietor
- X
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Foot & Ankle Surgery Podiatrist (213ES0103X)