Healthcare Provider Details

I. General information

NPI: 1306937263
Provider Name (Legal Business Name): DONALD FELDMAN DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 06/02/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1124 MAIN ST
PEEKSKILL NY
10566-2908
US

IV. Provider business mailing address

1124 MAIN ST
PEEKSKILL NY
10566-2908
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-2964
  • Fax: 914-737-0563
Mailing address:
  • Phone: 914-737-2964
  • Fax: 914-737-0563

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN004083
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberNOO4083
License Number StateNY

VIII. Authorized Official

Name: DONALLD FELDMAN
Title or Position: PODIATRIST
Credential: D.P.M.
Phone: 914-737-2964