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General NPI Number Information
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NPI Number | 1194070714
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Entity Type | Organization
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Legal Business Name | BRUCE L FELDMAN, MD, PLLC
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Dates
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Enumeration Date | 07/19/2012
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Last Update Date | 06/04/2021
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Provider Practice Location Address
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Address Line | 755 NEW YORK AVE STE 308
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City | HUNTINGTON
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State | NY
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Zip | 11743-4240
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Country | US
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Telephone | 516-588-8500
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Fax | 888-425-9273
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Provider Business Mailing Address
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Address Line | 44 CHESTNUT LN
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City | WOODBURY
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State | NY
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Zip | 11797-1913
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Country | US
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Telephone | 516-588-8500
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Fax | 888-425-9273
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Authorized Official
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Title or Position | MANAGING PHYSICIAN
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Name | DR. BRUCE LAWRENCE FELDMAN
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Credential | MD
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Telephone | 516-588-8500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 213830
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License Number State | NY
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