MEDICARE: REBECCA F FELDMAN RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	631586	NY
2	363LF0000X	Family Nurse Practitioner	341429	NY

General Provider Information

NPI Number	:	1083924542
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA F FELDMAN RN

Provider Business Mailing Address
First Line	:	1090 PENINSULA BLVD
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1542
Country	:	US
Telephone Number	:	732-267-8720
Fax Number	:

Provider Business Practice Location Address
First Line	:	1090 PENINSULA BLVD
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1542
Country	:	US
Telephone Number	:	732-267-8720
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/18/2010
Last Update Date	:	02/09/2017

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