Provider Demographics
NPI:1821144395
Name:FELDMAN, PHILIP M (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:M
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2979 W SCHOOL HOUSE LANE
Mailing Address - Street 2:APT K 804
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-5356
Mailing Address - Country:US
Mailing Address - Phone:215-848-6216
Mailing Address - Fax:215-848-3659
Practice Address - Street 1:6 WHITE HORSE PIKE
Practice Address - Street 2:
Practice Address - City:HADDON HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:08035-1246
Practice Address - Country:US
Practice Address - Phone:856-547-2822
Practice Address - Fax:215-848-3659
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMD007554182084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
FE712636Medicare ID - Type Unspecified