Individual
MARY EDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPA-C
Contact information
Practice address
1900 RIDGE RD, WEST SENECA, NY 14224-3332
(716) 712-0570
Mailing address
6805 LAKE SHORE RD, DERBY, NY 14047-9748
(716) 947-5568
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009301
NY
Other
Enumeration date
04/16/2007
Last updated
07/08/2007
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