Healthcare Provider Details

I. General information

NPI: 1598243685
Provider Name (Legal Business Name): HELEN FELDMAN PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2018
Last Update Date: 08/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 FORD AVE
MILLTOWN NJ
08850-1532
US

IV. Provider business mailing address

32 FORD AVE
MILLTOWN NJ
08850-1532
US

V. Phone/Fax

Practice location:
  • Phone: 732-777-1940
  • Fax: 732-777-1889
Mailing address:
  • Phone: 732-777-1940
  • Fax: 732-777-1889

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number35S100582600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: