Individual
MRS. ANN EDIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
TVI
Contact information
Practice address
597 3RD AVE, TROY, NY 12182-2509
(518) 233-0544
Mailing address
48 WAKEFIELD CT, DELMAR, NY 12054-2333
(518) 475-0620
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
194016021
NY
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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