Provider Demographics
NPI:1588662175
Name:FELDMAN, STEPHEN M (RPH)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:M
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MAPLE PL
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1810
Mailing Address - Country:US
Mailing Address - Phone:617-513-3656
Mailing Address - Fax:781-762-3999
Practice Address - Street 1:75 MAPLE PL
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1810
Practice Address - Country:US
Practice Address - Phone:617-513-3656
Practice Address - Fax:781-762-3999
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-08
Last Update Date:2013-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA158611835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy