Provider Demographics
NPI:1669896262
Name:STONE-EDWARDS, ZOETH M (NP)
Entity type:Individual
Prefix:
First Name:ZOETH
Middle Name:M
Last Name:STONE-EDWARDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1973 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-4404
Mailing Address - Country:US
Mailing Address - Phone:718-708-8000
Mailing Address - Fax:718-708-8001
Practice Address - Street 1:1973 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10453-4404
Practice Address - Country:US
Practice Address - Phone:718-708-8000
Practice Address - Fax:718-708-8001
Is Sole Proprietor?:No
Enumeration Date:2014-02-18
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338463-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist