Individual
CHRISTOPHER EDELSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
100 NICOLLS RD, STONY BROOK, NY 11790-3407
(631) 444-1000
Mailing address
201 MANOR PL, GREENPORT, NY 11944-1222
(631) 477-5144
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
007788-1
NY
363A00000X
Physician Assistant
Primary
007788
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0571PA
—
SC
Enumeration date
07/20/2006
Last updated
10/02/2018
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