Healthcare Provider Details

I. General information

NPI: 1285965251
Provider Name (Legal Business Name): REBECCA FELDMAN PMHNP, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/14/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7559 263RD ST
GLEN OAKS NY
11004-1150
US

IV. Provider business mailing address

75-59 263RD ST. ZUCKER HILLSIDE HOSPITAL
GLEN OAKS NY
11004
US

V. Phone/Fax

Practice location:
  • Phone: 917-855-7859
  • Fax:
Mailing address:
  • Phone: 917-855-7859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number9834963
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License NumberF001373
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: