Healthcare Provider Details

I. General information

NPI: 1376636191
Provider Name (Legal Business Name): DIANNE B FEUERSTEIN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 01/10/2023
Certification Date: 01/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 CRANFORD DR
NEW CITY NY
10956-5407
US

IV. Provider business mailing address

4 CRANFORD DR
NEW CITY NY
10956-5407
US

V. Phone/Fax

Practice location:
  • Phone: 845-664-4300
  • Fax:
Mailing address:
  • Phone: 845-664-4300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WN0300X
TaxonomyNephrology Registered Nurse
License NumberF334221
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF334221
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: