Individual
MICHAEL EIDELMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 W 19TH ST, GROUND FL, NEW YORK, NY 10011-4072
(212) 675-0549
(212) 675-0540
Mailing address
245 W 19TH ST, GROUND FL, NEW YORK, NY 10011-4072
(212) 675-0549
(212) 675-0540
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
209980
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01998356
—
NY
Enumeration date
11/16/2005
Last updated
03/17/2011
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