Provider Demographics
NPI:1982653606
Name:ADELMAN, ROBERT STEVEN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEVEN
Last Name:ADELMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:STEVEN
Other - Last Name:ADELMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPM
Mailing Address - Street 1:12888 MOUNT MADISON LN
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33473-3312
Mailing Address - Country:US
Mailing Address - Phone:212-254-2772
Mailing Address - Fax:212-254-6336
Practice Address - Street 1:11 FIFTH AVENUE
Practice Address - Street 2:SUITE A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-4342
Practice Address - Country:US
Practice Address - Phone:212-254-2772
Practice Address - Fax:212-254-6336
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-09
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002651-1213E00000X
NJ25MD00237200213E00000X
332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01470873Medicaid
NYT50835Medicare UPIN
NY5037920001Medicare NSC
NYP29851Medicare ID - Type Unspecified
NYP29851Medicare PIN