Healthcare Provider Details

I. General information

NPI: 1063684702
Provider Name (Legal Business Name): EMILY R FELZENBERG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2008
Last Update Date: 03/24/2026
Certification Date: 03/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 BROAD ST SUITE 317
RED BANK NJ
07701-2028
US

IV. Provider business mailing address

157 BROAD ST SUITE 317
RED BANK NJ
07701-2028
US

V. Phone/Fax

Practice location:
  • Phone: 732-530-2960
  • Fax: 732-530-7446
Mailing address:
  • Phone: 732-530-2960
  • Fax: 732-530-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberDO-06199
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number25MB08276700
License Number StateNJ
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberDO.2321
License Number StateAL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberDO.2321
License Number StateAL
# 5
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberE-13679
License Number StateAR
# 6
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02007035A
License Number StateIN
# 7
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number72695
License Number StateMN
# 8
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number5101026745
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: