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General NPI Number Information
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NPI Number | 1659547552
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Entity Type | Organization
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Legal Business Name | MARK A. FELDMAN M.D.
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Dates
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Enumeration Date | 05/01/2008
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Last Update Date | 11/29/2008
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Provider Practice Location Address
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Address Line | 101 PROSPECT ST SUITE 214
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5020
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Country | US
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Telephone | 732-370-6062
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Fax |
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Provider Business Mailing Address
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Address Line | 101 PROSPECT ST SUITE 214
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City | LAKEWOOD
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State | NJ
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Zip | 08701-5020
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Country | US
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Telephone | 732-370-6062
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Fax |
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Authorized Official
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Title or Position | ORTHOPEDIC SURGEON
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Name | DR. MARK ALLEN FELDMAN
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Credential | M.D.
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Telephone | 732-370-6062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207XX0801X
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Taxonomy Name | Orthopaedic Trauma Physician
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License Number | MA46457
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License Number State | NJ
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