Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 150872 | NY |
N | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 150872 | NY |
NPI | 1326146622 |
---|---|
Provider Name | Dr. Terri Gallen Edersheim |
First Address | New York, NY 10021-4099 |
Second Address | New York, NY 10021-4099 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B11989 | (02) | NY |