Provider Demographics
NPI:1386866945
Name:FELDBERG, ALAN (PHD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:FELDBERG
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:836 LONG LANE, APT. 3
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-3816
Mailing Address - Country:US
Mailing Address - Phone:717-749-3066
Mailing Address - Fax:
Practice Address - Street 1:10058 SOUTH MOUNTAIN ROAD
Practice Address - Street 2:
Practice Address - City:SOUTH MOUNTAIN
Practice Address - State:PA
Practice Address - Zip Code:17261
Practice Address - Country:US
Practice Address - Phone:717-749-3066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 008788L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist