Provider Demographics
NPI:1821095886
Name:FELD, JUDITH A (MD)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:A
Last Name:FELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:A
Other - Last Name:LEVINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4043 MAPLE RD
Mailing Address - Street 2:STE 107
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1057
Mailing Address - Country:US
Mailing Address - Phone:716-835-1246
Mailing Address - Fax:716-835-0396
Practice Address - Street 1:4043 MAPLE RD
Practice Address - Street 2:STE 107
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1057
Practice Address - Country:US
Practice Address - Phone:716-835-1246
Practice Address - Fax:716-835-0396
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY601915882084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1507889OtherINDEPENDENT HEALTH
NYDD0531Medicare ID - Type Unspecified
NY1507889OtherINDEPENDENT HEALTH