Provider Demographics
NPI:1316311699
Name:THOMPSON, EDWARD PALMER (DNP, NP-P)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:PALMER
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DNP, NP-P
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12305-2008
Mailing Address - Country:US
Mailing Address - Phone:518-346-1284
Mailing Address - Fax:
Practice Address - Street 1:61 ROWLAND ST STE 203
Practice Address - Street 2:
Practice Address - City:BALLSTON SPA
Practice Address - State:NY
Practice Address - Zip Code:12020-1135
Practice Address - Country:US
Practice Address - Phone:518-704-3866
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-24
Last Update Date:2023-11-09
Deactivation Date:2023-11-03
Deactivation Code:
Reactivation Date:2023-11-08
Provider Licenses
StateLicense IDTaxonomies
AL1-138734363LP0808X
NY402079363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health