Provider Demographics
NPI:1881647808
Name:FELDMAN, JESSICA A (MD)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:A
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 LAWN AVE
Mailing Address - Street 2:THE SUMMIT - SUITE 5
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-1560
Mailing Address - Country:US
Mailing Address - Phone:215-257-4900
Mailing Address - Fax:215-257-6681
Practice Address - Street 1:920 LAWN AVE
Practice Address - Street 2:THE SUMMIT - SUITE 5
Practice Address - City:SELLERSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18960-1560
Practice Address - Country:US
Practice Address - Phone:215-257-4900
Practice Address - Fax:215-257-6681
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD4250772084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1015476100001Medicaid
PA1015476100001Medicaid
PAI52516Medicare UPIN