Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 168611 | NY |
NPI | 1023075066 |
---|---|
Provider Name | David J Edelstein |
First Address | New York, NY 10041-0004 |
Second Address | Brooklyn, NY 11220 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 10/11/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01097878 | (05) | NY |
A62100 | (02) |