Provider Demographics
NPI:1174522569
Name:FELDER, JOSEPH B (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:B
Last Name:FELDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:115 E 57TH ST
Mailing Address - Street 2:STE. 510
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2049
Mailing Address - Country:US
Mailing Address - Phone:212-472-8039
Mailing Address - Fax:212-744-4072
Practice Address - Street 1:115 E 57TH ST
Practice Address - Street 2:STE. 510
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2049
Practice Address - Country:US
Practice Address - Phone:212-472-8039
Practice Address - Fax:212-744-4072
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-18
Last Update Date:2015-06-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY183784207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01506761Medicaid
NYF21998Medicare UPIN
NY01506761Medicaid