MEDICARE: DR. KATHRYN PAYNE EDWARDS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101242945	VA
2	207K00000X	Allergy & Immunology Physician	0101242945	VA
3	207K00000X	Allergy & Immunology Physician	MD462881	PA
4	208000000X	Pediatrics Physician	25MA10240200	NJ
5	208000000X	Pediatrics Physician	MD462881	PA
6	207K00000X	Allergy & Immunology Physician	25MA10240200	NJ

General Provider Information

NPI Number	:	1326197039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHRYN PAYNE EDWARDS M.D.

Provider Business Mailing Address
First Line	:	1 UNION ST STE 203
Second Line	:
City	:	ROBBINSVILLE
State	:	NJ
Zip	:	08691-4219
Country	:	US
Telephone Number	:	609-436-5740
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 UNION ST STE 203
Second Line	:
City	:	ROBBINSVILLE
State	:	NJ
Zip	:	08691-4219
Country	:	US
Telephone Number	:	609-436-5740
Fax Number	:	609-436-5741

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2007
Last Update Date	:	01/18/2019

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