=====================================================
General NPI Number Information
=====================================================
NPI Number | 1235448655
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | RANDI SALZMAN FELDMAN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/04/2010
-----------------------------------------------------
Last Update Date | 10/04/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23 CREEMER RD
-----------------------------------------------------
City | ARMONK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10504-2403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-273-1491
-----------------------------------------------------
Fax | 914-273-8570
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 23 CREEMER RD
-----------------------------------------------------
City | ARMONK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10504-2403
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 914-273-1491
-----------------------------------------------------
Fax | 914-273-8570
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208000000X
-----------------------------------------------------
Taxonomy Name | Pediatrics Physician
-----------------------------------------------------
License Number | 174568
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------