Provider Demographics
NPI:1316015613
Name:EDMAN, JOEL BARRY (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:BARRY
Last Name:EDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:529 STATE ROUTE 35
Mailing Address - Street 2:
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5037
Mailing Address - Country:US
Mailing Address - Phone:732-741-9800
Mailing Address - Fax:732-758-6367
Practice Address - Street 1:529 STATE ROUTE 35
Practice Address - Street 2:
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5037
Practice Address - Country:US
Practice Address - Phone:732-741-9800
Practice Address - Fax:732-758-6367
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA03780208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics