Healthcare Provider Details

I. General information

NPI: 1245252634
Provider Name (Legal Business Name): STEVEN IRA FELDMAN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

635 MADISON AVE SUITE 1301
NEW YORK NY
10022-1009
US

IV. Provider business mailing address

635 MADISON AVE SUITE 1301
NEW YORK NY
10022-1009
US

V. Phone/Fax

Practice location:
  • Phone: 212-755-8672
  • Fax: 212-755-2448
Mailing address:
  • Phone: 212-755-8672
  • Fax: 212-755-2448

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0700X
TaxonomyProsthodontics
License Number034829
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: