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:
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Health care specialties

SpecialtyCodeLicense #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 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063405819 NPPES
Connecticut MEDICAID 008047540
Connecticut MEDICAID 01301766
Connecticut MEDICAID 036094621
Connecticut Other 202926
Connecticut Other 212545

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