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General NPI Number Information
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NPI Number | 1659630580
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Entity Type | Individual
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Provider Name | CHARLES M EDELSTEIN DPM
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Gender | Male
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Dates
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Enumeration Date | 05/12/2012
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 1424 50TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219
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Country | US
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Telephone | 718-436-3400
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 50TH ST
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City | BROOKLYN
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State | NY
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Zip | 11219-3631
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Country | US
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Telephone | 718-436-3400
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | 25MD00315700
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 213ES0131X
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Taxonomy Name | Foot Surgery Podiatrist
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License Number | N006480
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License Number State | NY
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