Healthcare Provider Details

I. General information

NPI: 1154239200
Provider Name (Legal Business Name): SHELLY FEYGELMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 ENGLE ST
ENGLEWOOD NJ
07631-1808
US

IV. Provider business mailing address

613 4TH ST APT 205
HOBOKEN NJ
07030-7643
US

V. Phone/Fax

Practice location:
  • Phone: 201-894-3664
  • Fax:
Mailing address:
  • Phone: 206-492-0748
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: