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General NPI Number Information
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NPI Number | 1174670152
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Entity Type | Individual
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Provider Name | JOSEPH S EDWARDS M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2016 BRONXDALE AVE SUITE 202
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City | BRONX
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State | NY
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Zip | 10462-3388
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Country | US
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Telephone | 718-863-8695
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Fax | 718-863-5147
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Provider Business Mailing Address
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Address Line | 4422 3RD AVE DEPT OF SURGERY
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City | BRONX
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State | NY
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Zip | 10457-2545
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Country | US
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Telephone | 718-960-6127
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Fax | 718-960-6132
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 153953
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License Number State | NY
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