Provider Demographics
NPI:1013959261
Name:FELD, MICHAEL LAWRENCE (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:LAWRENCE
Last Name:FELD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-0066
Mailing Address - Country:US
Mailing Address - Phone:973-625-2099
Mailing Address - Fax:973-625-2692
Practice Address - Street 1:126 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-3307
Practice Address - Country:US
Practice Address - Phone:973-625-2099
Practice Address - Fax:973-625-2692
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-12
Last Update Date:2012-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC004489111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ535091OtherMEDICARE PTAN
NJX84971OtherEMPIRE BLUE CROSS BLUE SH
NJ903788OtherAMERIHEALTH
NJ5860347OtherAETNA
NJP432367OtherOXFORD
NJ535091OtherMEDICARE PTAN