Provider Demographics
NPI:1093535064
Name:EDELMAN, HANNAH G (RD)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:G
Last Name:EDELMAN
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 APOLLO DR APT D
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2923
Mailing Address - Country:US
Mailing Address - Phone:516-528-3570
Mailing Address - Fax:
Practice Address - Street 1:11221 DOLFIELD BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-3254
Practice Address - Country:US
Practice Address - Phone:443-213-8482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX6886133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered