Healthcare Provider Details

I. General information

NPI: 1851366066
Provider Name (Legal Business Name): BENJAMIN FELDSHUH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 E 37TH ST APT LBB
NEW YORK NY
10016-3124
US

IV. Provider business mailing address

245 E 35TH ST APT 106
NEW YORK CITY NY
10016-3124
US

V. Phone/Fax

Practice location:
  • Phone: 212-689-4320
  • Fax: 212-689-4320
Mailing address:
  • Phone: 212-684-7396
  • Fax: 212-689-4320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number092561
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: