Healthcare Provider Details
I. General information
NPI: 1689136012
Provider Name (Legal Business Name): JENNA FELDMAN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 04/04/2019
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1925 PACIFIC AVE 1ST FL STE 1511
ATLANTIC CITY NJ
08401
US
IV. Provider business mailing address
1925 PACIFIC AVE 1ST FL STE 1511
ATLANTIC CITY NJ
08401
US
V. Phone/Fax
- Phone: 609-441-8165
- Fax: 609-593-9850
- Phone: 609-441-8165
- Fax: 609-593-9850
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XX0801X |
| Taxonomy | Orthopaedic Trauma Physician |
| License Number | 58.034445 |
| License Number State | OH |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | 25MB12638300 |
| License Number State | NJ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: