Provider Demographics
NPI:1205229770
Name:SAINT JEAN, EDITH
Entity Type:Individual
Prefix:MISS
First Name:EDITH
Middle Name:
Last Name:SAINT JEAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 4 BROOKLYN AVE. # 1H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225
Mailing Address - Country:US
Mailing Address - Phone:646-338-0839
Mailing Address - Fax:
Practice Address - Street 1:474 BROOKLYN AVE APT 1H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4418
Practice Address - Country:US
Practice Address - Phone:646-338-0839
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-09
Last Update Date:2015-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264720-1251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care