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General NPI Number Information
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NPI Number | 1407886096
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Entity Type | Individual
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Provider Name | BRUCE LAWRENCE FELDMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/03/2006
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Last Update Date | 05/13/2021
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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 | 646-801-7541
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Fax | 888-425-9273
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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