MEDICARE: DR MICHAEL EDELSTEIN

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	332B00000X	Durable Medical Equipment & Medical Supplies

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	:	1801057070
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DR MICHAEL EDELSTEIN

Provider Business Mailing Address
First Line	:	3 WICKS DR
Second Line	:
City	:	COMMACK
State	:	NY
Zip	:	11725-3921
Country	:	US
Telephone Number	:	718-561-0041
Fax Number	:	718-561-0188

Provider Business Practice Location Address
First Line	:	3224 GRAND CONCOURSE APT BA
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10458-1067
Country	:	US
Telephone Number	:	718-561-0041
Fax Number	:	718-561-0188

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MICHAEL EDELSTEIN
Credential	:
Telephone Number	:	718-561-0041

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	06/20/2008

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