Individual
EDNA J WHITE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 W MAIN ST APT 311, RIVERHEAD, NY 11901-2800
(631) 295-8631
Mailing address
11 W MAIN ST APT 311, RIVERHEAD, NY 11901-2800
(631) 295-8631
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04082020725525
—
NY
05
—
1972132199
—
NY
Enumeration date
04/08/2020
Last updated
04/09/2020
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