Provider Demographics
NPI:1831922137
Name:EDGAR, TAYLOR JANE
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:JANE
Last Name:EDGAR
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 FRONT ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905-3102
Mailing Address - Country:US
Mailing Address - Phone:315-955-4248
Mailing Address - Fax:
Practice Address - Street 1:13 CHRISFIELD AVE
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:NY
Practice Address - Zip Code:13790-2700
Practice Address - Country:US
Practice Address - Phone:607-793-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker