Organization
WASSER & EDELSTEIN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY S EDELSTEIN OD (OWNER)
(856) 779-7595
Entity
Organization
Contact information
Practice address
38 W MAIN ST, MAPLE SHADE, NJ 08052-2432
(856) 779-7595
(856) 779-7596
Mailing address
38 W MAIN ST, MAPLE SHADE, NJ 08052-2432
(856) 779-7595
(856) 779-7596
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4996
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0747818000
BC BS PA
—
01
—
568665
BC/BS PA
—
05
—
641310201
—
NJ
Enumeration date
05/21/2006
Last updated
02/03/2011
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