Provider Demographics
NPI:1316305469
Name:EDWARDS, SHAMADA (PMHNP)
Entity type:Individual
Prefix:
First Name:SHAMADA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:281 NATHAN D PERLMAN PL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003
Mailing Address - Country:US
Mailing Address - Phone:212-749-8093
Mailing Address - Fax:
Practice Address - Street 1:281 NATHAN D PERLMAN PL
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-598-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-03
Last Update Date:2025-10-17
Deactivation Date:2019-12-10
Deactivation Code:
Reactivation Date:2025-10-01
Provider Licenses
StateLicense IDTaxonomies
NY406489363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty