MEDICARE: DR. ELISE N. FELDMAN PH.D.

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	103TC0700X	Clinical Psychologist	018764	NY

General Provider Information

NPI Number	:	1871790279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELISE N. FELDMAN PH.D.

Provider Business Mailing Address
First Line	:	142 JORALEMON ST STE 720
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4747
Country	:	US
Telephone Number	:	646-470-9686
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 JORALEMON ST STE 720
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-4747
Country	:	US
Telephone Number	:	646-470-9686
Fax Number	:

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

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	11/19/2024

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