Provider Demographics
NPI:1467525386
Name:PRYCE, EDITH HENRIETTA (MD)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:HENRIETTA
Last Name:PRYCE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:EDITH
Other - Middle Name:HENRIETTA
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:50 PROSPECT AVENUE
Mailing Address - Street 2:
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078
Mailing Address - Country:US
Mailing Address - Phone:518-773-3881
Mailing Address - Fax:518-773-8813
Practice Address - Street 1:50 PROSPECT AVENUE
Practice Address - Street 2:
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-773-3881
Practice Address - Fax:518-773-8813
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01759273Medicaid
NY01759273Medicaid
B93721Medicare UPIN