Provider Demographics
NPI:1639382757
Name:FRANK, EDITH ADELE (PHD)
Entity Type:Individual
Prefix:DR
First Name:EDITH
Middle Name:ADELE
Last Name:FRANK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3935 BLACKSTONE AVE
Mailing Address - Street 2:10G
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-3721
Mailing Address - Country:US
Mailing Address - Phone:718-884-7025
Mailing Address - Fax:
Practice Address - Street 1:3935 BLACKSTONE AVE
Practice Address - Street 2:10G
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-3721
Practice Address - Country:US
Practice Address - Phone:718-884-7025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00184100103T00000X
NY0066091103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical