Provider Demographics
NPI:1659327963
Name:FELSENSTEIN, SIDNEY (DPM)
Entity Type:Individual
Prefix:DR
First Name:SIDNEY
Middle Name:
Last Name:FELSENSTEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180-05 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11432
Mailing Address - Country:US
Mailing Address - Phone:718-526-6300
Mailing Address - Fax:718-262-7064
Practice Address - Street 1:1000 ZECKENDORF BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530-2133
Practice Address - Country:US
Practice Address - Phone:516-542-6880
Practice Address - Fax:516-542-5556
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2013-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN002037213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00413507Medicaid
NY00413507Medicaid
NY9255UZMedicare PIN