Individual
EDWARD O FESTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D,RPA
Contact information
Practice address
8209 ROOSEVELT AVE FL 2, JACKSON HEIGHTS, NY 11372-7034
(718) 507-8000
Mailing address
PO BOX 995, WILLIAMSBRIDGE STN, BRONX, NY 10467-0726
(914) 672-6858
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004555-1
NY
Other
Enumeration date
11/03/2006
Last updated
07/08/2007
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