Provider Demographics
NPI:1659046639
Name:FEIDNER, ELLEN M
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:M
Last Name:FEIDNER
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 1:3 E PULTENEY SQ
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:NY
Mailing Address - Zip Code:14810-1510
Mailing Address - Country:US
Mailing Address - Phone:607-664-2438
Mailing Address - Fax:607-664-2166
Practice Address - Street 1:3 E PULTENEY SQ
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:NY
Practice Address - Zip Code:14810-1510
Practice Address - Country:US
Practice Address - Phone:607-664-2438
Practice Address - Fax:607-664-2166
Is Sole Proprietor?:No
Enumeration Date:2021-08-12
Last Update Date:2021-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator