Individual
EDMEE M HENRIQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7315 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1144
(718) 424-2788
(718) 424-3513
Mailing address
7315 NORTHERN BLVD, JACKSON HEIGHTS, NY 11372-1144
(718) 424-2788
(718) 424-3513
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
218863
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02109415
—
NY
01
—
80187139
RR
—
Enumeration date
08/23/2006
Last updated
12/31/2022
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