Provider Demographics
NPI:1750372173
Name:FELDMAN, HAL D (MD)
Entity type:Individual
Prefix:
First Name:HAL
Middle Name:D
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:PO BOX 719
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-0719
Mailing Address - Country:US
Mailing Address - Phone:631-423-2642
Mailing Address - Fax:631-423-1364
Practice Address - Street 1:33 WALT WHITMAN RD
Practice Address - Street 2:SUITE 104
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3640
Practice Address - Country:US
Practice Address - Phone:631-423-2642
Practice Address - Fax:631-423-1364
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-03
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206042-1207X00000X, 207XX0005X, 207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYH91090Medicare UPIN
NY642D31Medicare PIN