Provider Demographics
NPI:1104008713
Name:FELDMAN, MARINA (MD)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 SAINT NICHOLAS AVE APT 57
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-5253
Mailing Address - Country:US
Mailing Address - Phone:917-648-8325
Mailing Address - Fax:888-524-8265
Practice Address - Street 1:930 SAINT NICHOLAS AVE APT 57
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-5253
Practice Address - Country:US
Practice Address - Phone:917-648-8325
Practice Address - Fax:888-524-8265
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY264800207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYA400085231Medicare PIN