Provider Demographics
NPI:1164684536
Name:FELDSTEIN, JAY S (DO)
Entity Type:Individual
Prefix:DR
First Name:JAY
Middle Name:S
Last Name:FELDSTEIN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:404 KILGRASS TER
Mailing Address - Street 2:
Mailing Address - City:AVONDALE
Mailing Address - State:PA
Mailing Address - Zip Code:19311-1351
Mailing Address - Country:US
Mailing Address - Phone:610-268-0142
Mailing Address - Fax:
Practice Address - Street 1:404 KILGRASS TER
Practice Address - Street 2:
Practice Address - City:AVONDALE
Practice Address - State:PA
Practice Address - Zip Code:19311-1351
Practice Address - Country:US
Practice Address - Phone:610-268-0142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-27
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC200022132083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine