Provider Demographics
NPI:1477795276
Name:EDMAN, DONNA M
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:EDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4545
Mailing Address - Country:US
Mailing Address - Phone:718-735-5966
Mailing Address - Fax:718-735-5178
Practice Address - Street 1:480 MAPLE ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4545
Practice Address - Country:US
Practice Address - Phone:718-735-5966
Practice Address - Fax:718-735-5178
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-26
Last Update Date:2009-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health