Marc Daniel Edma

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

26NP07398600 Issued in NJ

Practice address

435 53Rd St Apt D5
West New York, NJ 07093-2058

Phone

(201) 455-9825

NPI assigned

Dec 10, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mr. Marc Daniel Edma Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607558400000",
    "number": "1558967976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "435 53RD ST APT D5",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932058",
            "telephone_number": "201-455-9825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "435 53RD ST APT D5",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932058",
            "telephone_number": "201-455-9825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMA",
        "first_name": "MARC",
        "middle_name": "DANIEL",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-12-10",
        "last_updated": "2020-12-10",
        "certification_date": "2020-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NJ",
            "license": "26NP07398600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARC",
            "last_name": "EDMA",
            "middle_name": "DANIEL",
            "prefix": "MR.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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• Licensed Practical Nurse in West New York, NJ
• Providers in West New York, NJ by specialty
• Licensed Practical Nurse in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.