Healthcare Provider Details

I. General information

NPI: 1750007720
Provider Name (Legal Business Name): ANGEL FELDMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2022
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 5TH AVE FL 2
NEW YORK NY
10003-1030
US

IV. Provider business mailing address

50 E 28TH ST APT 7L
NEW YORK NY
10016-7971
US

V. Phone/Fax

Practice location:
  • Phone: 212-754-6639
  • Fax:
Mailing address:
  • Phone: 908-377-7411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number350287
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: