Provider Demographics
NPI:1891899894
Name:NAAMON, EDWIN LEROY (MD)
Entity type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:LEROY
Last Name:NAAMON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:622 W 168TH ST
Mailing Address - Street 2:PH 1-137 ASSOCIATES W EMERGENCY SERVICES CUMC
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3720
Mailing Address - Country:US
Mailing Address - Phone:212-305-2995
Mailing Address - Fax:212-305-6792
Practice Address - Street 1:622 W 168 STREET
Practice Address - Street 2:PH 1137 COLUMBIA UNIVERSITY MED CENTER
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3784
Practice Address - Country:US
Practice Address - Phone:212-305-2995
Practice Address - Fax:212-305-6792
Is Sole Proprietor?:No
Enumeration Date:2006-09-11
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY152784207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01355173Medicaid
NY66K561Medicare ID - Type Unspecified
F30399Medicare UPIN