Healthcare Provider Details

I. General information

NPI: 1750372173
Provider Name (Legal Business Name): HAL D FELDMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2005
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 Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number206042-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number206042-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License Number206042-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: