Healthcare Provider Details

I. General information

NPI: 1912384314
Provider Name (Legal Business Name): JOSHUA BRADLEY FELDMAN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2015
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6511 SPRING BROOK AVE
RHINEBECK NY
12572-3709
US

IV. Provider business mailing address

259 1ST ST
MINEOLA NY
11501-3957
US

V. Phone/Fax

Practice location:
  • Phone: 845-876-3001
  • Fax:
Mailing address:
  • Phone: 516-663-2105
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number297190
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: