Organization
SJ ALL MEDICAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELLEN EDGAR MD (PRESIDENT)
(718) 790-7530
Entity
Organization
Contact information
Practice address
139 N CENTRAL AVE, SUITE 3, VALLEY STREAM, NY 11580-3856
(718) 544-4200
(718) 544-4201
Mailing address
1311 BRIGHTWATER AVE APT 18IJ, BROOKLYN, NY 11235-5962
(718) 544-4200
(718) 544-4201
Taxonomy
Speciality
Code
Description
License number
State
2084N0600X
Clinical Neurophysiology Physician
Primary
—
NY
Other
Enumeration date
05/27/2014
Last updated
05/27/2014
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