Individual
DR. RICHARD D EDELSTEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
154 DUCHESS STREET, NEWPORT, VT 05855-0724
(802) 334-6744
(802) 334-7450
Mailing address
PO BOX 724, NEWPORT, VT 05855-0724
(802) 334-6744
(802) 334-7450
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
420007067
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0005084
—
VT
01
—
VT508401
MEDICARE PTAN
VT
Enumeration date
12/08/2006
Last updated
04/30/2012
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