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NPI Code Detail

MEDICARE: MICHAEL EDNIE MD NJ PC

MEDICARE: MICHAEL EDNIE MD NJ PC
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
11041C0700XClinical Social Worker
2225100000XPhysical Therapist
3225X00000XOccupational Therapist
4363L00000XNurse Practitioner

General Provider Information

NPI Number : 1558212647
Entity Type Code : Organization
Provider Name (Legal Business Name) : MICHAEL EDNIE MD NJ PC
Provider Business Mailing Address
First Line : 300 1ST AVE STE 103
Second Line :
City : NEEDHAM
State : MA
Zip : 02494-2759
Country : US
Telephone Number : 857-990-6111
Fax Number :
Provider Business Practice Location Address
First Line : 820 BEAR TAVERN RD
Second Line :
City : EWING
State : NJ
Zip : 08628-1021
Country : US
Telephone Number : 857-990-6111
Fax Number :
Authorized Official
Title or Position : VP GENERAL MANAGER
Name : ASHLEY ROBINSON
Credential :
Telephone Number : 850-687-6000
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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