Provider Demographics
NPI:1275539926
Name:EDELSTEIN, NORMAN L (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:L
Last Name:EDELSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:338 RED OAK CT
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-3100
Mailing Address - Country:US
Mailing Address - Phone:412-855-9626
Mailing Address - Fax:412-373-6825
Practice Address - Street 1:338 RED OAK CT
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-3100
Practice Address - Country:US
Practice Address - Phone:412-855-9626
Practice Address - Fax:412-373-6825
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-27
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD012372E207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B40371Medicare UPIN
161774QCMMedicare ID - Type Unspecified