Provider Demographics
NPI:1407886096
Name:FELDMAN, BRUCE LAWRENCE (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:LAWRENCE
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:44 CHESTNUT LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1913
Mailing Address - Country:US
Mailing Address - Phone:646-801-7541
Mailing Address - Fax:888-425-9273
Practice Address - Street 1:755 NEW YORK AVE STE 308
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4240
Practice Address - Country:US
Practice Address - Phone:516-588-8500
Practice Address - Fax:888-425-9273
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-05-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY213830207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAE65755Medicare UPIN