Individual ProviderNicole B EdgarSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersPractice Address98 Beechwood Pl, Staten Island, NY 10314-3064(646) 483-9009PECOS EnrollmentBased on the most recent information from CMS, provider Nicole B Edgar does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1407155542Provider TypeIndividualFull NameEdgar, Nicole BGenderFemaleSole ProprietorYesEnumeration Date3/15/2011Last Updated3/15/2011Contact InformationPractice LocationPractice Address98 Beechwood Pl, Staten Island, NY 10314-3064Phone(646) 483-9009FaxUnlisted FaxMailing LocationMailing Address98 Beechwood Pl, Staten Island, NY 10314-3064Phone(646) 483-9009FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode235Z00000XPrimaryDescriptionSpeech-Language PathologistSpeech, Language and Hearing Service ProvidersLicense017576-1New York