Provider Demographics
NPI:1518019421
Name:FELDMAN, SHARON LYNN (OD)
Entity type:Individual
Prefix:DR
First Name:SHARON
Middle Name:LYNN
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 725
Mailing Address - Street 2:
Mailing Address - City:COOPERSTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13326-0725
Mailing Address - Country:US
Mailing Address - Phone:607-547-3140
Mailing Address - Fax:607-547-6574
Practice Address - Street 1:1 ATWELL RD
Practice Address - Street 2:
Practice Address - City:COOPERSTOWN
Practice Address - State:NY
Practice Address - Zip Code:13326-1301
Practice Address - Country:US
Practice Address - Phone:607-547-3140
Practice Address - Fax:607-547-6574
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2012-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV0006139-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYU81324Medicare UPIN
NYC66011Medicare ID - Type Unspecified
NYC66012Medicare ID - Type Unspecified