Provider Demographics
NPI:1164645198
Name:FELDMAN, JUSTIN NATHANIEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:JUSTIN
Middle Name:NATHANIEL
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:258 TITUSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3248
Mailing Address - Country:US
Mailing Address - Phone:845-475-8769
Mailing Address - Fax:845-746-2298
Practice Address - Street 1:258 TITUSVILLE RD
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3248
Practice Address - Country:US
Practice Address - Phone:845-475-8769
Practice Address - Fax:845-746-2298
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0288701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist