Organization
EDEN TREE MEDICAL
Active
Organization
EDEN TREE MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIN SHERIDAN RN (VICE PRESIDENT, COO)
(917) 693-5738
Entity
Organization
Contact information
Practice address
107 RIDGE RD, VALLEY COTTAGE, NY 10989-2466
(845) 770-4686
Mailing address
107 RIDGE RD, VALLEY COTTAGE, NY 10989-2466
(845) 770-4686
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598480337
NPI
NY
Enumeration date
10/04/2022
Last updated
10/04/2022
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