Provider Demographics
NPI:1326293192
Name:EDWARDS, DENISE BARRIE (MS,PT)
Entity Type:Individual
Prefix:MS
First Name:DENISE
Middle Name:BARRIE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2944 BROWER AVE
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11572-3340
Mailing Address - Country:US
Mailing Address - Phone:516-766-5396
Mailing Address - Fax:516-766-5396
Practice Address - Street 1:2944 BROWER AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:NY
Practice Address - Zip Code:11572-3340
Practice Address - Country:US
Practice Address - Phone:516-766-5396
Practice Address - Fax:516-766-5396
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY09107225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics