MEDICARE: MRS. BETH FELDMAN

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	235Z00000X	Speech-Language Pathologist		NY

General Provider Information

NPI Number	:	1619112331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. BETH FELDMAN

Provider Business Mailing Address
First Line	:	107 LEFFERTS RD
Second Line	:
City	:	WOODMERE
State	:	NY
Zip	:	11598-1314
Country	:	US
Telephone Number	:	516-569-0926
Fax Number	:

Provider Business Practice Location Address
First Line	:	1854 CORNAGA AVE
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-4304
Country	:	US
Telephone Number	:	718-471-5854
Fax Number	:

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

Provider Enumeration Date	:	12/09/2008
Last Update Date	:	12/09/2008

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