Provider Demographics
NPI:1740253772
Name:FELDSTEIN, BRAD (MD)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:
Last Name:FELDSTEIN
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 1:1615 LIMEKILN PIKE
Mailing Address - Street 2:
Mailing Address - City:DRESHER
Mailing Address - State:PA
Mailing Address - Zip Code:19025-1053
Mailing Address - Country:US
Mailing Address - Phone:215-643-7331
Mailing Address - Fax:215-654-0741
Practice Address - Street 1:1615 LIMEKILN PIKE
Practice Address - Street 2:
Practice Address - City:DRESHER
Practice Address - State:PA
Practice Address - Zip Code:19025-1053
Practice Address - Country:US
Practice Address - Phone:215-643-7331
Practice Address - Fax:215-654-0741
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2021-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD028590E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA00161847900008Medicaid
E68114Medicare UPIN