EDEN TREE MEDICAL NPI 1093430837

NPI Information

NPI: 1093430837
Provider Name: EDEN TREE MEDICAL
Classification: Registered Nurse - 163WG0000X
Entity Type: Organization

Specialization: General Practice

Address:
107 RIDGE RD
VALLEY COTTAGE, NY
ZIP 10989
Phone: (845) 770-4686
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EDEN TREE MEDICAL is a general practice registered nurse in Valley Cottage, NY. EDEN TREE MEDICAL NPI is 1093430837. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

107 RIDGE RD
VALLEY COTTAGE, NY
ZIP 10989-466
Phone: (845) 770-4686

The provider's authorized official is Martin Sheridan .
The authorized official title is Vice President, Coo and has the following contact phone number (917) 693-5738.

The enumeration date for this NPI number is 10/4/2022 and was last updated on 10/4/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WG0000X	Registered Nurse	General Practice			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1598480337	OTHER	NEW YORK	NPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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