Provider Demographics
NPI:1568705549
Name:QUINT FELDMAN, BETSY WYLIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:WYLIE
Last Name:QUINT FELDMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:MISS
Other - First Name:BETSY
Other - Middle Name:WYLIE
Other - Last Name:QUINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:15 QUAIL RD
Mailing Address - Street 2:
Mailing Address - City:MASTIC BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11951-6407
Mailing Address - Country:US
Mailing Address - Phone:631-398-1972
Mailing Address - Fax:
Practice Address - Street 1:15 QUAIL RD
Practice Address - Street 2:
Practice Address - City:MASTIC BEACH
Practice Address - State:NY
Practice Address - Zip Code:11951-6407
Practice Address - Country:US
Practice Address - Phone:631-398-1972
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-28
Last Update Date:2013-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health