Provider Demographics
NPI:1417299470
Name:FELDMAN, MAYA (CCC-SLP)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1743 CRESCENT DR
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5884
Mailing Address - Country:US
Mailing Address - Phone:914-671-3993
Mailing Address - Fax:
Practice Address - Street 1:1743 CRESCENT DR
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-5884
Practice Address - Country:US
Practice Address - Phone:914-671-3993
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-17
Last Update Date:2013-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015109-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist