Healthcare Provider Details

I. General information

NPI: 1407902018
Provider Name (Legal Business Name): ALICIA B FELDMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2007
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3810 GRANT AVE
LOVELAND CO
80538
US

IV. Provider business mailing address

5803 LOCKHEED AVE STE 200
LOVELAND CO
80538-7027
US

V. Phone/Fax

Practice location:
  • Phone: 970-221-9451
  • Fax: 855-856-6479
Mailing address:
  • Phone: 970-221-9451
  • Fax: 855-856-6479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number52746
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number24685
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: