Healthcare Provider Details

I. General information

NPI: 1063358240
Provider Name (Legal Business Name): ZLATA FELDMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 TEANECK RD APT 519
TEANECK NJ
07666-3661
US

IV. Provider business mailing address

1500 TEANECK RD APT 519
TEANECK NJ
07666-3661
US

V. Phone/Fax

Practice location:
  • Phone: 917-391-8333
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number15BC00338400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: