MEDICARE: SHARON E JORDAN FELDMAN M.S.W.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	44SC00583700	NJ
2	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1033343488
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON E JORDAN FELDMAN M.S.W.

Provider Business Mailing Address
First Line	:	23 POTTER AVE
Second Line	:	SUITE 1
City	:	NEWTON
State	:	NJ
Zip	:	07860-9777
Country	:	US
Telephone Number	:	973-786-5913
Fax Number	:	973-786-5913

Provider Business Practice Location Address
First Line	:	17 WOODPORT RD
Second Line	:	SUITE 2C
City	:	SPARTA
State	:	NJ
Zip	:	07871-1933
Country	:	US
Telephone Number	:	973-786-5913
Fax Number	:	973-786-5913

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2009
Last Update Date	:	05/11/2010

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