Provider Demographics
NPI:1275130890
Name:FELDPAUSCH, MORGAN RAE (DPT)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:RAE
Last Name:FELDPAUSCH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:MORGAN
Other - Middle Name:RAE
Other - Last Name:FERGUSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1377 MOTOR PKWY STE 307
Mailing Address - Street 2:
Mailing Address - City:ISLANDIA
Mailing Address - State:NY
Mailing Address - Zip Code:11749-5258
Mailing Address - Country:US
Mailing Address - Phone:631-580-5200
Mailing Address - Fax:631-824-9335
Practice Address - Street 1:3751 S STATE RD
Practice Address - Street 2:
Practice Address - City:IONIA
Practice Address - State:MI
Practice Address - Zip Code:48846-9478
Practice Address - Country:US
Practice Address - Phone:616-522-0066
Practice Address - Fax:616-527-1667
Is Sole Proprietor?:No
Enumeration Date:2020-10-06
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501019713OtherSTATE LICENSE