Provider Demographics
NPI:1619189156
Name:EDITH H. PRYCE, M.D.
Entity Type:Organization
Organization Name:EDITH H. PRYCE, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDITH
Authorized Official - Middle Name:H
Authorized Official - Last Name:PRYCE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:518-773-3881
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196215207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01759273Medicaid
NY01759273Medicaid