Edelstein, Michael K
Edelstein, Michael K is an individual health care provider with primary practice located at 446 Moody St , Waltham MA 02453-0415. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Edelstein, Michael K can be contacted via phone (781) 899-3200.Contact Information
Primary practice address
446 Moody St
Waltham MA 02453-0415
Phone: (781) 899-3200
Fax: (781) 894-4645
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2402 | Massachusetts |
| Eye and Vision Services Providers / Optometrist | 152W00000X | 2402TP | Massachusetts |
Profile Details
| NPI number | 1043296213 |
|---|---|
| LBN Legal business name | Edelstein, Michael K |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 20th, 2005 |
| Last updated | Apr 2nd, 2008 - about 16 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 | 1043296213 | NPPES |
| Massachusetts | MEDICAID | 0322121 | |
| Massachusetts | Other | W16223 |
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