Edelman, Mark A
Edelman, Mark A is an individual health care provider with primary practice located at 1290 Summer St Ste 2100 , Stamford CT 06905-5340. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Edelman, Mark A can be contacted via phone (855) 830-8346.Contact Information
Primary practice address
1290 Summer St Ste 2100
Stamford CT 06905-5340
Phone: (855) 830-8346
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036094621 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 036094621 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 172012-1 | New York |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 51858 | Connecticut |
Profile Details
| NPI number | 1063405819 |
|---|---|
| LBN Legal business name | Edelman, Mark A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 26th, 2005 |
| Last updated | Jun 4th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063405819 | NPPES |
| Connecticut | MEDICAID | 008047540 | |
| Connecticut | MEDICAID | 01301766 | |
| Connecticut | MEDICAID | 036094621 | |
| Connecticut | Other | 202926 | |
| Connecticut | Other | 212545 |
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