Provider Demographics
NPI:1447856612
Name:FELDMAN, MICHAEL (LMT)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 CEDAR LN
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-2403
Mailing Address - Country:US
Mailing Address - Phone:914-960-1647
Mailing Address - Fax:
Practice Address - Street 1:89 5TH AVE STE 306
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3020
Practice Address - Country:US
Practice Address - Phone:914-960-1647
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-11
Last Update Date:2020-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029408225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist