Provider Demographics
NPI:1447469333
Name:FELDMAN, YAEL
Entity type:Individual
Prefix:DR
First Name:YAEL
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:530 W 236TH ST
Mailing Address - Street 2:#6F
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-1748
Mailing Address - Country:US
Mailing Address - Phone:718-344-9006
Mailing Address - Fax:
Practice Address - Street 1:39 BROADWAY
Practice Address - Street 2:#2115
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-3003
Practice Address - Country:US
Practice Address - Phone:212-422-9229
Practice Address - Fax:212-742-0928
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051996-11223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry