Provider Demographics
NPI:1114162146
Name:DAVID M. EDELSTEIN, MD, PC
Entity Type:Organization
Organization Name:DAVID M. EDELSTEIN, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:MARC
Authorized Official - Last Name:EDELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PC
Authorized Official - Phone:718-646-8787
Mailing Address - Street 1:2382 EAST 13 STREET
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-4306
Mailing Address - Country:US
Mailing Address - Phone:718-646-8787
Mailing Address - Fax:718-646-0098
Practice Address - Street 1:2382 EAST 13 STREET
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-4306
Practice Address - Country:US
Practice Address - Phone:718-646-8787
Practice Address - Fax:718-646-0098
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY237998207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty