Judith Karen Adelstein, APRN

Individual provider Active NPI Pediatric Nurse Practitioner · Fairfield, CT

NPI 1013045277 · NPPES record last updated Feb 28, 2015

Key facts

NPI
1013045277
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nurse Practitioner 363LP0200X
License
002754 (CT)
Practice address
189 Veres St
Fairfield, CT 06824-6447
Phone
(203) 464-7493
NPI assigned
Mar 1, 2007
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
002754CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Raphael Faculty Physicians Past Accepting new patients
Saint Raphael Healthcare System Affiliated Physicians Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 002754 CT Yes

Addresses

Primary practice location

189 Veres St
Fairfield, CT 06824-6447

Mailing address

267 Grant St
Bridgeport, CT 06610-2805
Phone (203) 384-3199

Other providers in Fairfield, CT

All providers in Fairfield, CT · Pediatric Nurse Practitioner in Connecticut

Sources for this page

Verify at the official NPI Registry.