Provider Demographics
NPI:1720089303
Name:RELKIN, FELICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:
Last Name:RELKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 ELM ST
Mailing Address - Street 2:
Mailing Address - City:HARRINGTON PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07640-1902
Mailing Address - Country:US
Mailing Address - Phone:201-784-0123
Mailing Address - Fax:201-784-0065
Practice Address - Street 1:24 ELM ST
Practice Address - Street 2:
Practice Address - City:HARRINGTON PARK
Practice Address - State:NJ
Practice Address - Zip Code:07640-1902
Practice Address - Country:US
Practice Address - Phone:201-784-0123
Practice Address - Fax:201-784-0065
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA06356900207R00000X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ38N782OtherEMPIRE BC/BS (TE) #
NJ8149305Medicaid
NJP1855315OtherOXFORD #
NJ0087326000OtherAMERIHEALTH ID #
NJ2286524OtherAETNA HMO ID #
NJ1K4055OtherHEALTHNET ID #
NJ38N781OtherEMPIRE HC (HP) #
NJ4568646OtherAETNA PPO ID #
NJ38N783OtherEMPIRE BC/BS (NV) #
NJ8149305Medicaid
NJ4568646OtherAETNA PPO ID #