Provider Demographics
NPI:1003140765
Name:FELDERMAN DERMATOLOGY LLC
Entity type:Organization
Organization Name:FELDERMAN DERMATOLOGY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LENORA
Authorized Official - Middle Name:IRMA
Authorized Official - Last Name:FELDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD , DO
Authorized Official - Phone:212-734-0091
Mailing Address - Street 1:74 E 79TH ST APT 1B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10075-0266
Mailing Address - Country:US
Mailing Address - Phone:212-734-0091
Mailing Address - Fax:212-861-8456
Practice Address - Street 1:74 E 79TH ST APT 1B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10075-0266
Practice Address - Country:US
Practice Address - Phone:212-734-0091
Practice Address - Fax:212-861-8456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-29
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1159201174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty