Provider Demographics
NPI:1669500393
Name:FELDMAN, CECILE ARLENE (DMD)
Entity Type:Individual
Prefix:
First Name:CECILE
Middle Name:ARLENE
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SALTER DR
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07045-9322
Mailing Address - Country:US
Mailing Address - Phone:973-331-0160
Mailing Address - Fax:
Practice Address - Street 1:110 BERGEN STREET
Practice Address - Street 2:NEW JERSEY DENTAL SCHOOL
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07103
Practice Address - Country:US
Practice Address - Phone:973-972-4634
Practice Address - Fax:973-972-3689
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI01534122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist