Provider Demographics
NPI:1649233578
Name:EDELMAN, ROBERT A (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:A
Last Name:EDELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2800 MARCUS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1113
Mailing Address - Country:US
Mailing Address - Phone:516-622-6196
Mailing Address - Fax:516-608-2889
Practice Address - Street 1:601 FRANKLIN AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-5795
Practice Address - Country:US
Practice Address - Phone:516-742-3200
Practice Address - Fax:516-746-5847
Is Sole Proprietor?:No
Enumeration Date:2006-04-11
Last Update Date:2015-08-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY124044208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
D38967Medicare UPIN