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General NPI Number Information
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NPI Number | 1770477929
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Entity Type | Individual
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Provider Name | DENIS ALI EDER LMHC
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Gender | Male
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Dates
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Enumeration Date | 06/04/2025
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Last Update Date | 06/04/2025
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Provider Practice Location Address
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Address Line | 135 VANDERBILT AVE
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City | STATEN ISLAND
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State | NY
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Zip | 10304-2604
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Country | US
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Telephone | 888-515-3834
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Fax |
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Provider Business Mailing Address
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Address Line | 84 MAYBERRY PROMENADE
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City | STATEN ISLAND
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State | NY
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Zip | 10312-6407
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Country | US
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Telephone | 347-782-7297
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 016054
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License Number State | NY
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