Provider Demographics
NPI:1457754269
Name:FEITMAN, FAIGI
Entity Type:Individual
Prefix:MRS
First Name:FAIGI
Middle Name:
Last Name:FEITMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:FAIGE
Other - Middle Name:
Other - Last Name:DERMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:52 BRIDLE RD
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-1729
Mailing Address - Country:US
Mailing Address - Phone:732-900-0918
Mailing Address - Fax:
Practice Address - Street 1:40 GRANDVIEW AVE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-1626
Practice Address - Country:US
Practice Address - Phone:845-517-5388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-07
Last Update Date:2014-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ582273174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist