Provider Demographics
NPI:1457326563
Name:FELDMAN, LUDMILA B (MD)
Entity Type:Individual
Prefix:DR
First Name:LUDMILA
Middle Name:B
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:289 FRIAR LN
Mailing Address - Street 2:
Mailing Address - City:MOUNTAINSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:07092-1358
Mailing Address - Country:US
Mailing Address - Phone:718-667-3800
Mailing Address - Fax:718-980-9281
Practice Address - Street 1:27 NEW DORP LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-2322
Practice Address - Country:US
Practice Address - Phone:718-667-3597
Practice Address - Fax:718-667-3590
Is Sole Proprietor?:No
Enumeration Date:2006-02-22
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2070112084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02107986Medicaid
NYH43463Medicare UPIN
NY374N6G2841Medicare PIN