Healthcare Provider Details

I. General information

NPI: 1265601090
Provider Name (Legal Business Name): HAL D. FELDMAN, M.D., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 WALT WHITMAN RD SUITE 104
HUNTINGTON STATION NY
11746-3640
US

IV. Provider business mailing address

PO BOX 719
MERRICK NY
11566-0719
US

V. Phone/Fax

Practice location:
  • Phone: 631-423-2642
  • Fax: 631-423-1364
Mailing address:
  • Phone: 631-423-2642
  • Fax: 631-423-1364

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number206042
License Number StateNY

VIII. Authorized Official

Name: HAL D. FELDMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 631-423-2642