Organization
JOHN W. EDELGLASS M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN WARREN EDELGLASS M.D. (PRESIDENT)
(203) 389-1185
Entity
Organization
Contact information
Practice address
1 BRADLEY RD, SUITE 705, WOODBRIDGE, CT 06525-2285
(203) 389-1185
(203) 389-1427
Mailing address
1 BRADLEY RD, SUITE 705, WOODBRIDGE, CT 06525-2285
(203) 389-1185
(203) 389-1427
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
023280
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C00153
MEDICARE GROUP
CT
Enumeration date
07/20/2007
Last updated
08/12/2007
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