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General NPI Number Information
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NPI Number | 1790770980
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Entity Type | Individual
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Provider Name | STEPHEN B ADELSTEIN OD
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Gender | Male
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Dates
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Enumeration Date | 09/14/2005
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Last Update Date | 01/22/2008
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Provider Practice Location Address
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Address Line | 11 SUMMER ST UNIT 1
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City | CHELMSFORD
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State | MA
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Zip | 01824-3064
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Country | US
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Telephone | 978-256-5731
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Fax | 978-256-1553
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Provider Business Mailing Address
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Address Line | PO BOX 298 11 SUMMER ST
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City | CHELMSFORD
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State | MA
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Zip | 01824-0298
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Country | US
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Telephone | 978-256-5731
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Fax | 978-256-1553
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3089
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License Number State | MA
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