Provider Demographics
NPI:1629071014
Name:FELDMAN, KIRA (MD)
Entity Type:Individual
Prefix:DR
First Name:KIRA
Middle Name:
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 1:160 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:BARNEGAT
Mailing Address - State:NJ
Mailing Address - Zip Code:08005-2061
Mailing Address - Country:US
Mailing Address - Phone:609-607-0210
Mailing Address - Fax:
Practice Address - Street 1:249 S MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:BARNEGAT
Practice Address - State:NJ
Practice Address - Zip Code:08005-2301
Practice Address - Country:US
Practice Address - Phone:609-607-1010
Practice Address - Fax:609-601-9992
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA0709702080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ23864OtherAETNA/USHC HMO PROVIDER #
NJP2068029OtherOXFORD PROVIDER ID #
NH5845148005OtherCIGNA PROVIDER ID #
NJ2010619OtherUNITED HEALTH CARE PROV #
NJ60011030OtherHORIZON NJ HEALTH PROV. #
NJ202119279100OtherQUALCARE PROVIDER ID #
NH89319OtherAMERIGROUP PROVIDER ID #
NJK5402OtherHORIZON BC/BS PROVIDER #
NJ2K5970OtherHEALTHNET PROVIDER ID #
NJ7755130OtherAETNA/USHC PPO PROVIDER #
NJ2354758001OtherAMERIHEALTH PROVIDER ID #
NJ8334200OtherUNISYS NUMBER
NJK5402OtherHORIZON BC/BS PROVIDER #