Healthcare Provider Details

I. General information

NPI: 1033127006
Provider Name (Legal Business Name): ROBERT T ADELSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 05/18/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 SPRUCE STREET 5 SILVERSTEIN BUILDING
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

400 PATROON CREEK BLVD
ALBANY NY
12206-5312
US

V. Phone/Fax

Practice location:
  • Phone: 215-662-2777
  • Fax:
Mailing address:
  • Phone: 518-701-2138
  • Fax: 518-701-2139

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberME92345
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD441427
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: