Provider Demographics
NPI:1164024766
Name:EDELMAN, MENACHEM YOSEF (PHARM D)
Entity type:Individual
Prefix:DR
First Name:MENACHEM
Middle Name:YOSEF
Last Name:EDELMAN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6223 BALTIMORE NATIONAL PIKE # 117
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-2910
Mailing Address - Country:US
Mailing Address - Phone:410-788-6220
Mailing Address - Fax:844-411-6236
Practice Address - Street 1:6223-25 BALTIMORE NATIONAL PIKE
Practice Address - Street 2:GIANT PHARMACY 117
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228
Practice Address - Country:US
Practice Address - Phone:410-788-6220
Practice Address - Fax:844-411-6236
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21583183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist