Individual
EDWARD SHALTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9520 63RD RD STE H, REGO PARK, NY 11374-1145
(718) 864-2120
(888) 603-6374
Mailing address
725 RIVER RD, SUITE 32-79, EDGEWATER, NJ 07020-1171
(646) 301-2578
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
209237
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01807432
—
NY
Enumeration date
12/04/2006
Last updated
01/28/2021
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