Individual
DR. MARK R. EDISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1165 PARK AVE, SUITE 1-B, NEW YORK, NY 10128-1210
(917) 399-5594
Mailing address
1165 PARK AVE, SUITE 1-B, NEW YORK, NY 10128-1210
(917) 399-5594
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
016913-1
NY
Other
Enumeration date
11/02/2009
Last updated
11/02/2009
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