Provider Demographics
NPI:1881818557
Name:FELDMAN, REBECCA L (APRN, BC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:L
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:APRN, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 UNION ST STE 205
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-7700
Mailing Address - Country:US
Mailing Address - Phone:508-647-0222
Mailing Address - Fax:508-647-0333
Practice Address - Street 1:67 UNION ST STE 205
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-7700
Practice Address - Country:US
Practice Address - Phone:508-647-0222
Practice Address - Fax:508-647-0333
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA251484364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA464901OtherTUFTS HEALTH PLAN
MAPN0792OtherBLUE CROSS BLUE SHIELDPPO
MA415560OtherMAGELLAN
MAFE NS 0660Medicare ID - Type Unspecified