Provider Demographics
NPI:1023639184
Name:FELLER, ADRIENNE (HEC-C)
Entity type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:
Last Name:FELLER
Suffix:
Gender:F
Credentials:HEC-C
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:
Other - Last Name:NOVICK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:HEC-C
Mailing Address - Street 1:76 RAYMOND PL
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2310
Mailing Address - Country:US
Mailing Address - Phone:516-642-1099
Mailing Address - Fax:
Practice Address - Street 1:27005 76TH AVE DEPT OF
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1402
Practice Address - Country:US
Practice Address - Phone:516-470-5840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-29
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYHEC-C174V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174V00000XOther Service ProvidersClinical Ethicist