Provider Demographics
NPI:1700825890
Name:FELDMAN, JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15934 RIVERSIDE DR W
Mailing Address - Street 2:APT# 7JK
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-1014
Mailing Address - Country:US
Mailing Address - Phone:551-996-3192
Mailing Address - Fax:201-968-1866
Practice Address - Street 1:30 PROSPECT AVE
Practice Address - Street 2:ETD- 3 MAIN RM 3619
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-1914
Practice Address - Country:US
Practice Address - Phone:551-996-3192
Practice Address - Fax:201-968-1866
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05881400207PE0004X
NY191369207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJF64885Medicare UPIN
NJ011828DHKMedicare ID - Type Unspecified