Individual
DR. JESSICA LAUREN EDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2605 HARLEM RD, CHEEKTOWAGA, NY 14225-4018
(716) 891-2400
Mailing address
62043 COLLEEN CT, WASHINGTON, MI 48094-1000
(248) 225-1556
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
289530
NY
207P00000X
Emergency Medicine Physician
Primary
4301113955
MI
390200000X
Student in an Organized Health Care Education/Training Program
125065518
IL
Other
Enumeration date
06/26/2014
Last updated
02/02/2021
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