Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NS0005X | Chiropractic Sports Physician | 100 | MA |
Y | 111NS0005X | Chiropractic Sports Physician | 270A | NH |
NPI | 1295811735 |
---|---|
Provider Name | Andrew Edelstein |
First Address | Plaistow, NH 03865-2928 |
Second Address | Plaistow, NH 03865-2928 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2006 |
Last Update Date | 08/07/2007 |