Provider Demographics
NPI:1760650121
Name:FELDMAN, IRIT
Entity Type:Individual
Prefix:
First Name:IRIT
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 BEACON ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02116-1236
Mailing Address - Country:US
Mailing Address - Phone:617-435-9762
Mailing Address - Fax:857-277-1260
Practice Address - Street 1:264 BEACON ST
Practice Address - Street 2:3RD FLOOR
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-1236
Practice Address - Country:US
Practice Address - Phone:617-435-9762
Practice Address - Fax:857-277-1260
Is Sole Proprietor?:No
Enumeration Date:2008-02-19
Last Update Date:2016-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA9370103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health