Individual ProviderTaedra PedontiSocial WorkerBehavioral Health & Social Service ProvidersPractice Address622 West 168th St, Vc4-East Room 403, New York, NY 11211(212) 305-7248PECOS EnrollmentBased on the most recent information from CMS, provider Taedra Pedonti 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 9:43 AM.Profile DetailsProvider ID1760909303Provider TypeIndividualFull NamePedonti, TaedraCredentialLCSWGenderFemaleSole ProprietorNoEnumeration Date8/24/2017Last Updated5/16/2022Contact InformationPractice LocationPractice Address622 West 168th St, Vc4-East Room 403, New York, NY 11211Phone(212) 305-7248FaxUnlisted FaxMailing LocationMailing Address622 West 168th St., Vc4- East Room 403, New York, NY 11211Phone(212) 305-7248FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode1041C0700XPrimaryDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense093119-01New YorkCode1041C0700XDescriptionSocial WorkerBehavioral Health & Social Service ProvidersLicense100887New York