Provider Demographics
NPI:1417992611
Name:WLADIS, EDWARD J (MD)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:J
Last Name:WLADIS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1220 NEW SCOTLAND RD
Mailing Address - Street 2:SUITE 302
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-9396
Mailing Address - Country:US
Mailing Address - Phone:518-533-6540
Mailing Address - Fax:518-533-6542
Practice Address - Street 1:1220 NEW SCOTLAND RD
Practice Address - Street 2:SUITE 302
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-9396
Practice Address - Country:US
Practice Address - Phone:518-533-6540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-19
Last Update Date:2016-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY247116207WX0200X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology