Provider Demographics
NPI:1902375843
Name:FELDMAN, STACY LYNN
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:LYNN
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 1:802 NORWICH COURT
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17112-2723
Mailing Address - Country:US
Mailing Address - Phone:717-773-5108
Mailing Address - Fax:
Practice Address - Street 1:802 NORWICH CT
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17112-2723
Practice Address - Country:US
Practice Address - Phone:717-773-5108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-21
Last Update Date:2018-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP042995R183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist