MEDICARE: EDELORBE LLC

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	207RN0300X	Nephrology Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1427795517
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDELORBE LLC

Provider Business Mailing Address
First Line	:	603 W 148TH ST APT 9B
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10031-3135
Country	:	US
Telephone Number	:	347-930-0280
Fax Number	:	718-347-4643

Provider Business Practice Location Address
First Line	:	116 E 124TH ST
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10035-1924
Country	:	US
Telephone Number	:	646-979-3316
Fax Number	:	646-979-3320

Authorized Official
Title or Position	:	PHYSICIAN
Name	:	DR. EDUARDO J DEL ORBE
Credential	:	MD
Telephone Number	:	917-862-5215

Provider Enumeration Date	:	05/19/2022
Last Update Date	:	05/19/2022

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Directions to “EDELORBE LLC ” Practice Location

Language	Start Address	Practice Location

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