Provider Demographics
NPI:1063684702
Name:FELZENBERG, EMILY R (DO)
Entity Type:Individual
Prefix:DR
First Name:EMILY
Middle Name:R
Last Name:FELZENBERG
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:157 BROAD ST
Mailing Address - Street 2:SUITE 317
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-2028
Mailing Address - Country:US
Mailing Address - Phone:732-530-2960
Mailing Address - Fax:732-530-7446
Practice Address - Street 1:157 BROAD ST
Practice Address - Street 2:SUITE 317
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-2028
Practice Address - Country:US
Practice Address - Phone:732-530-2960
Practice Address - Fax:732-530-7446
Is Sole Proprietor?:No
Enumeration Date:2008-04-01
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ALDO.2321207P00000X, 207R00000X
NJ25MB08276700207R00000X
IN02007035A207R00000X
MI5101026745207R00000X
ARE-13679207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0052426Medicaid
NJ0157040Medicaid
NJ91002808500OtherAMERICHOICE
NJ0052426Medicaid
NJ0157040Medicaid