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General NPI Number Information
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NPI Number | 1437608643
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Entity Type | Individual
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Provider Name | EDWIDGE MICHEL
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Gender | Female
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Dates
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Enumeration Date | 09/28/2016
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Last Update Date | 02/16/2025
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Provider Practice Location Address
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Address Line | 100 E 77TH ST
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City | NEW YORK
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State | NY
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Zip | 10075-1850
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Country | US
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Telephone | 212-434-3015
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Fax |
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Provider Business Mailing Address
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Address Line | 2930 BAYSWATER AVE
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City | FAR ROCKAWAY
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State | NY
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Zip | 11691-1730
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Country | US
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Telephone | 917-830-4641
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Fax |
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 084258-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 099364
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License Number State | NY
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