Edington, Jeremiah Carrol

Edington, Jeremiah Carrol is an individual health care provider with primary practice located at 1228 E Main St Ste C , Riverhead NY 11901-2677. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Edington, Jeremiah Carrol can be contacted via phone (631) 603-3400.

Contact Information

Primary practice address
1228 E Main St Ste C Riverhead NY 11901-2677
Phone: (631) 603-3400
Fax: (631) 603-3401
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 015287 New York

Profile Details

NPI number 1134405632
LBN Legal business name Edington, Jeremiah Carrol
Credentials RPA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 27th, 2011
Last updated Mar 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134405632 NPPES
New York MEDICAID 05937706

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