Provider Demographics
NPI:1891059390
Name:EDER, LOIS ANN (MSED)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:ANN
Last Name:EDER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 S JACKSON AVE
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3812
Mailing Address - Country:US
Mailing Address - Phone:732-742-6345
Mailing Address - Fax:732-937-9110
Practice Address - Street 1:47 S JACKSON AVE
Practice Address - Street 2:
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3812
Practice Address - Country:US
Practice Address - Phone:732-742-6345
Practice Address - Fax:732-937-9110
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist