Basic Information
| Provider Information | |||||||||
| NPI: | 1528145109 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDMUNDS | ||||||||
| FirstName: | EMME | ||||||||
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| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37 DIETZ ST | ||||||||
| Address2: | |||||||||
| City: | ONEONTA | ||||||||
| State: | NY | ||||||||
| PostalCode: | 138201882 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6074322252 | ||||||||
| FaxNumber: | 6074327206 | ||||||||
| Practice Location | |||||||||
| Address1: | 117 HAWLEY ST | ||||||||
| Address2: | |||||||||
| City: | BINGHAMTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 139013903 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6077235130 | ||||||||
| FaxNumber: | 6077234087 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/01/2006 | ||||||||
| LastUpdateDate: | 03/13/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LW0102X | F420566-1 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 367A00000X | F000837-1 | NY | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
ID Information
| ID | Type | State | Issuer | Description | 03436844 | 05 | NY | MEDICAID |