Provider Demographics
NPI:1942575840
Name:EDELSHTEYN, DINA
Entity Type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:EDELSHTEYN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6410 VETERANS AVE
Mailing Address - Street 2:STE 202
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5605
Mailing Address - Country:US
Mailing Address - Phone:347-462-2780
Mailing Address - Fax:
Practice Address - Street 1:6410 VETERANS AVE
Practice Address - Street 2:STE 202
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5605
Practice Address - Country:US
Practice Address - Phone:347-462-2780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2012-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other