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Individual

EDGARDO BONFANTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
460 W 34TH ST, NEW YORK, NY 10001-2320
(212) 273-6100
Mailing address
390 SMITH ST, CENTRAL ISLIP, NY 11722-3726

Taxonomy

Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary

Other

Enumeration date
07/12/2012
Last updated
07/12/2012
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