Provider Demographics
NPI:1700239183
Name:EDGAR, BRITTANY (PMHNP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:EDGAR
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 WALL ST PH 10
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10005-1961
Mailing Address - Country:US
Mailing Address - Phone:617-869-5511
Mailing Address - Fax:
Practice Address - Street 1:75 MAIDEN LN RM 401
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10038-4650
Practice Address - Country:US
Practice Address - Phone:631-265-1622
Practice Address - Fax:631-265-3042
Is Sole Proprietor?:No
Enumeration Date:2016-07-20
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY709640163W00000X
NYF402300363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse