Provider Demographics
NPI:1750534640
Name:FELDMANN, KAREN M (MT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:FELDMANN
Suffix:
Gender:F
Credentials:MT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 VIRGINIA AVE
Mailing Address - Street 2:
Mailing Address - City:LAKE RONKONKOMA
Mailing Address - State:NY
Mailing Address - Zip Code:11779-1517
Mailing Address - Country:US
Mailing Address - Phone:631-834-9719
Mailing Address - Fax:631-758-1660
Practice Address - Street 1:987 N OCEAN AVE
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:NY
Practice Address - Zip Code:11763-3532
Practice Address - Country:US
Practice Address - Phone:631-834-9719
Practice Address - Fax:631-758-1660
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-23
Last Update Date:2008-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006044225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist