Provider Demographics
NPI:1295709004
Name:FELDMAN, ALAN H (DPM)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:H
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 BLAKE ST
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-1287
Mailing Address - Country:US
Mailing Address - Phone:203-397-0624
Mailing Address - Fax:203-397-0372
Practice Address - Street 1:2499 MAIN ST
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06615-5843
Practice Address - Country:US
Practice Address - Phone:203-377-0003
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-16
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00339213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004057402Medicaid
T22114Medicare UPIN