Healthcare Provider Details

I. General information

NPI: 1497865471
Provider Name (Legal Business Name): SYDELE ELLA FELDMAN DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 FIFTH STREET SUITE 205
SANTA FE NM
87505
US

IV. Provider business mailing address

1911 FIFTH STREET SUITE 205
SANTA FE NM
87505
US

V. Phone/Fax

Practice location:
  • Phone: 505-995-8851
  • Fax:
Mailing address:
  • Phone: 505-995-8851
  • Fax: 505-995-8658

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberNM1341
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: