Provider Demographics
NPI:1508663790
Name:FELDSTEIN, BROOKE BRACHA (PSYD)
Entity type:Individual
Prefix:DR
First Name:BROOKE
Middle Name:BRACHA
Last Name:FELDSTEIN
Suffix:
Gender:
Credentials:PSYD
Other - Prefix:DR
Other - First Name:BROOKE
Other - Middle Name:BRACHA
Other - Last Name:KASIRER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1705 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5006
Mailing Address - Country:US
Mailing Address - Phone:718-864-0216
Mailing Address - Fax:
Practice Address - Street 1:1705 NOBLE ST
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-5006
Practice Address - Country:US
Practice Address - Phone:718-864-0216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024865103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist