Provider Demographics
NPI:1801864699
Name:EPSTEIN, DAVID I (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:I
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:100 RIVERSIDE DR
Mailing Address - Street 2:APT.#18D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-4822
Mailing Address - Country:US
Mailing Address - Phone:201-362-1549
Mailing Address - Fax:212-787-3169
Practice Address - Street 1:500 GRAND AVE
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-4967
Practice Address - Country:US
Practice Address - Phone:220-136-2154
Practice Address - Fax:212-787-3169
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-09
Last Update Date:2008-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07371600207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
F88292Medicare UPIN
NJ057481BBSMedicare ID - Type Unspecified