Individual ProviderEdgardo BonfantePsychologistBehavioral Health & Social Service ProvidersPractice Address460 W 34th St, New York, NY 10001-2320(212) 273-6100PECOS EnrollmentBased on the most recent information from CMS, provider Edgardo Bonfante does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1760747919Provider TypeIndividualFull NameBonfante, EdgardoCredentialM.S.GenderMaleSole ProprietorNoEnumeration Date7/12/2012Last Updated7/12/2012Contact InformationPractice LocationPractice Address460 W 34th St, New York, NY 10001-2320Phone(212) 273-6100FaxUnlisted FaxMailing LocationMailing Address390 Smith St, Central Islip, NY 11722-3726PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode103TS0200XPrimaryDescriptionPsychologistBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer