1225136989 NPI number — SYLVIA ALEXANDRA EDELSTEIN MD

Table of content: MS. ADRIENNE J ADAMS-MCAFEE (NPI 1952143760)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225136989 NPI number — SYLVIA ALEXANDRA EDELSTEIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EDELSTEIN
Provider First Name:
SYLVIA
Provider Middle Name:
ALEXANDRA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MANDLER
Provider Other First Name:
SYLVIA
Provider Other Middle Name:
EDELSTEIN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225136989
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/11/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 103
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CABIN JOHN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20818-0103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-320-6665
Provider Business Mailing Address Fax Number:
301-320-6699

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7945 MACARTHUR BLVD
Provider Second Line Business Practice Location Address:
#200A
Provider Business Practice Location Address City Name:
CABIN JOHN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-320-6665
Provider Business Practice Location Address Fax Number:
301-320-6699
Provider Enumeration Date:
09/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2084N0402X , with the licence number:  0101233140 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0402X , with the licence number: MD33699 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2084N0402X , with the licence number: D0062342 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 010135290 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 034243800 , issued by the state of ( DC ) . This identifiers is of the category "MEDICAID".




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