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Individual

MR. EDNER REGISTRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
11572 FRANCIS LEWIS BLVD, CAMBRIA HEIGHTS, NY 11411-1028
(718) 276-8666
Mailing address
166 ROQUETTE AVE, ELMONT, NY 11003-1209
(347) 679-5443

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
006837
NY
213E00000X
Podiatrist
Primary
R93136
NY

Other

Enumeration date
06/28/2014
Last updated
06/01/2018
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