Provider Demographics
NPI:1710130232
Name:FELSENFELD, MARK JARRET (MSPT)
Entity Type:Individual
Prefix:MR
First Name:MARK
Middle Name:JARRET
Last Name:FELSENFELD
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 FARMERS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-3032
Mailing Address - Country:US
Mailing Address - Phone:845-225-6239
Mailing Address - Fax:
Practice Address - Street 1:909 FARMERS MILLS RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-3032
Practice Address - Country:US
Practice Address - Phone:845-225-6239
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022274-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics