Provider Demographics
NPI:1083924542
Name:FELDMAN, REBECCA F (RN)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:F
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 PENINSULA BLVD
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1542
Mailing Address - Country:US
Mailing Address - Phone:732-267-8720
Mailing Address - Fax:
Practice Address - Street 1:1090 PENINSULA BLVD
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-1542
Practice Address - Country:US
Practice Address - Phone:732-267-8720
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-18
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY631586163W00000X
NY341429363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse