Provider Demographics
NPI:1356894018
Name:FELDMAN, BORIS DAVID (PHARMD)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:DAVID
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BYBERRY RD
Mailing Address - Street 2:APT E11
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19116-1947
Mailing Address - Country:US
Mailing Address - Phone:267-608-5000
Mailing Address - Fax:
Practice Address - Street 1:4616 N BROAD ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19140-1218
Practice Address - Country:US
Practice Address - Phone:215-239-4840
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP450074183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist