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Individual

MICHAEL CHARLES EDELSTEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
3224 GRAND CONCOURSE, SUITE #BA, BRONX, NY 10458
(718) 561-0041
(718) 561-0188
Mailing address
3 WICKS DR, COMMACK, NY 11725-3921
(718) 561-0041
(718) 561-0188

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N005269
NY
332B00000X
Durable Medical Equipment & Medical Supplies

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01739239
NY
Enumeration date
05/27/2005
Last updated
02/17/2009
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