Provider Demographics
NPI:1225136989
Name:EDELSTEIN, SYLVIA ALEXANDRA (MD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:ALEXANDRA
Last Name:EDELSTEIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SYLVIA
Other - Middle Name:EDELSTEIN
Other - Last Name:MANDLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:CABIN JOHN
Mailing Address - State:MD
Mailing Address - Zip Code:20818-0103
Mailing Address - Country:US
Mailing Address - Phone:301-320-6665
Mailing Address - Fax:301-320-6699
Practice Address - Street 1:7945 MACARTHUR BLVD
Practice Address - Street 2:#200A
Practice Address - City:CABIN JOHN
Practice Address - State:MD
Practice Address - Zip Code:20818
Practice Address - Country:US
Practice Address - Phone:301-320-6665
Practice Address - Fax:301-320-6699
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012331402084N0402X
DCMD336992084N0402X
MDD00623422084N0402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010135290Medicaid
DC034243800Medicaid