Provider Demographics
NPI:1346612439
Name:AUSFELD, EDWARD JOSEPH JR (MS)
Entity Type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:AUSFELD
Suffix:JR
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:11-21 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078-3968
Mailing Address - Country:US
Mailing Address - Phone:518-725-4310
Mailing Address - Fax:518-725-2556
Practice Address - Street 1:11-21 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078-3968
Practice Address - Country:US
Practice Address - Phone:518-725-4310
Practice Address - Fax:518-725-2556
Is Sole Proprietor?:No
Enumeration Date:2015-10-28
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health