Provider Demographics
NPI:1679886410
Name:FERA, FELICIA MARGARET (MS)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:MARGARET
Last Name:FERA
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:447 E 14TH ST
Mailing Address - Street 2:APT 3A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-2719
Mailing Address - Country:US
Mailing Address - Phone:646-701-1965
Mailing Address - Fax:
Practice Address - Street 1:447 E 14TH ST
Practice Address - Street 2:APT 3A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-2719
Practice Address - Country:US
Practice Address - Phone:646-701-1965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58 017058235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist