Provider Demographics
NPI:1518966852
Name:FIGUEROA, EDGAR (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:EDGAR
Middle Name:
Last Name:FIGUEROA
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 YORK AVE
Mailing Address - Street 2:BOX 258
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-4805
Mailing Address - Country:US
Mailing Address - Phone:646-962-6942
Mailing Address - Fax:646-962-1491
Practice Address - Street 1:230 E 69TH ST
Practice Address - Street 2:SUITE 2BB
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-5705
Practice Address - Country:US
Practice Address - Phone:646-962-6942
Practice Address - Fax:646-962-1491
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY60-222055207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I00846Medicare UPIN