Provider Demographics
NPI:1992041701
Name:EDMONDS, JEFFREY W
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:W
Last Name:EDMONDS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 STATE ROUTE 7
Mailing Address - Street 2:STE 1
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-5740
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2403 STATE ROUTE 7
Practice Address - Street 2:STE 1
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-5740
Practice Address - Country:US
Practice Address - Phone:518-234-8840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist