Healthcare Provider Details

I. General information

NPI: 1609979764
Provider Name (Legal Business Name): LYNN S. FELDMAN D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 12/31/2020
Certification Date: 12/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2501 NORTH GLEBE ROAD #303
ARLINGTON MD
22207
US

IV. Provider business mailing address

13121 BROOKLANE DR
HAGERSTOWN MD
21742-1514
US

V. Phone/Fax

Practice location:
  • Phone: 703-841-1290
  • Fax: 703-841-1315
Mailing address:
  • Phone: 301-345-0807
  • Fax: 301-474-7991

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberH29026
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberH29026
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: