Healthcare Provider Details

I. General information

NPI: 1124102579
Provider Name (Legal Business Name): STUART FELDMAN RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 NORTH SALEM ROAD
CROSS RIVER NY
10518
US

IV. Provider business mailing address

80 STALLION TRL
BREWSTER NY
10509-4707
US

V. Phone/Fax

Practice location:
  • Phone: 914-763-3152
  • Fax: 914-763-6567
Mailing address:
  • Phone: 845-278-6399
  • Fax: 914-763-6567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number33683
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: