Provider Demographics
NPI:1164866786
Name:FELDMAN, ELIZABETH SARA (SLP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:SARA
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24216 PINE ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1833
Mailing Address - Country:US
Mailing Address - Phone:516-702-3353
Mailing Address - Fax:
Practice Address - Street 1:24216 PINE ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1833
Practice Address - Country:US
Practice Address - Phone:516-702-3353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist