Provider Demographics
NPI:1528213014
Name:FELDBERG, SHOSHANA S
Entity Type:Individual
Prefix:MRS
First Name:SHOSHANA
Middle Name:S
Last Name:FELDBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1517 E 37TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-3417
Mailing Address - Country:US
Mailing Address - Phone:718-376-3415
Mailing Address - Fax:866-870-4279
Practice Address - Street 1:1517 E 37TH ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3417
Practice Address - Country:US
Practice Address - Phone:718-376-3415
Practice Address - Fax:866-870-4279
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-25
Last Update Date:2008-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012698-1225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist