Healthcare Provider Details

I. General information

NPI: 1720036809
Provider Name (Legal Business Name): DAVID MARC EDELSTEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 04/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 57TH STREET
BROOKLYN NY
11219
US

IV. Provider business mailing address

927 49TH STREET
BROOKLYN NY
11219
US

V. Phone/Fax

Practice location:
  • Phone: 718-283-8927
  • Fax: 718-283-6199
Mailing address:
  • Phone: 718-283-8927
  • Fax: 718-283-6199

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number237998
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number237998
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: