Individual provider · Type 1 NPI
Edward John Bonavilla, DPM
Foot & Ankle Surgery Podiatrist · Rochester, NY
NPI number
1629030960
Active
Practice location
490 Titus Ave
Rochester, NY 14617-3541
Fax (585) 544-4567
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | 002178 (NY) |
Foot & Ankle Surgery Podiatrist: Definition to come...
2 other providers at this address
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About NPI 1629030960
Edward John Bonavilla, DPM's National Provider Identifier is 1629030960, issued on Apr 3, 2006. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Rochester, NY. The record was last updated on Jul 13, 2026.