Provider Demographics
NPI:1891427910
Name:EDELSTEIN, DANIELLE (APN-C)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:EDELSTEIN
Suffix:
Gender:F
Credentials:APN-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1673 ROUTE 88 W
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-3071
Mailing Address - Country:US
Mailing Address - Phone:732-458-2000
Mailing Address - Fax:732-458-4523
Practice Address - Street 1:1673 ROUTE 88 W
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08724-3071
Practice Address - Country:US
Practice Address - Phone:732-458-2000
Practice Address - Fax:732-458-4523
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ01328300164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NJ01328300OtherLICENSE