Healthcare Provider Details

I. General information

NPI: 1386550051
Provider Name (Legal Business Name): AYALA FEDER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2026
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 CENTRAL AVE STE G
CEDARHURST NY
11516-2301
US

IV. Provider business mailing address

733 CORNAGA CT
FAR ROCKAWAY NY
11691-5307
US

V. Phone/Fax

Practice location:
  • Phone: 347-309-5362
  • Fax:
Mailing address:
  • Phone: 516-808-5875
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132506
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: