Provider Demographics
NPI:1689728743
Name:FELDMAN, LOIS M (RN)
Entity Type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:M
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 HAYRICK LN
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-1523
Mailing Address - Country:US
Mailing Address - Phone:631-462-9708
Mailing Address - Fax:
Practice Address - Street 1:104 HAYRICK LN
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-1523
Practice Address - Country:US
Practice Address - Phone:631-462-9708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY329066-1163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02416291Medicaid