Individual
DR. TINA B. EDMONSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
200 FEDERAL ST, SUITE 437, CAMDEN, NJ 08103-1061
(856) 963-0573
(856) 541-6037
Mailing address
200 FEDERAL ST, SUITE 437, CAMDEN, NJ 08103-1061
(856) 963-0573
(856) 541-6037
Taxonomy
Speciality
Code
Description
License number
State
207ZP0007X
Molecular Genetic Pathology (Pathology) Physician
MD421051
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD421051
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0043141
—
NJ
05
—
101103749
—
PA
Enumeration date
08/03/2006
Last updated
09/27/2011
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