Individual
DR. JUANA I EDMUNDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3811 BROADWAY, 3RD FLOOR, ASTORIA, NY 11103-4045
(718) 726-5953
(718) 204-5308
Mailing address
245 E 54TH ST, # 29 A, NEW YORK, NY 10022-4707
(212) 319-8069
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
133090
NY
2084P0804X
Child & Adolescent Psychiatry Physician
133090
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00753984
—
NY
Enumeration date
03/30/2006
Last updated
04/18/2012
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