MEDICARE: DR. JOEL K EDELSTEIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	MD019418E	PA

General Provider Information

NPI Number	:	1306061049
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL K EDELSTEIN M.D.

Provider Business Mailing Address
First Line	:	101 WASHINGTON LN
Second Line	:	SUITE G1
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-3505
Country	:	US
Telephone Number	:	215-576-5977
Fax Number	:

Provider Business Practice Location Address
First Line	:	101 WASHINGTON LN
Second Line	:	SUITE G1
City	:	JENKINTOWN
State	:	PA
Zip	:	19046-3505
Country	:	US
Telephone Number	:	215-576-5977
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	01/09/2014

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