Provider Demographics
NPI:1770673162
Name:EDLUND, BARBARA A (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:A
Last Name:EDLUND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 STATE ROUTE 49
Mailing Address - Street 2:PO BOX 311
Mailing Address - City:CONSTANTIA
Mailing Address - State:NY
Mailing Address - Zip Code:13044-0311
Mailing Address - Country:US
Mailing Address - Phone:315-623-9426
Mailing Address - Fax:
Practice Address - Street 1:321 GENESEE ST
Practice Address - Street 2:ONEIDA HEALTHCARE CENTER
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421
Practice Address - Country:US
Practice Address - Phone:315-363-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138458207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYBB8084Medicare UPIN