Provider Demographics
NPI:1821348046
Name:FEELEY, KATARINA MALAIKA (FNP)
Entity type:Individual
Prefix:MRS
First Name:KATARINA
Middle Name:MALAIKA
Last Name:FEELEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:KATARINA
Other - Middle Name:MALAIKA
Other - Last Name:FEELEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:20 GRAND ST FL 3
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-1035
Mailing Address - Country:US
Mailing Address - Phone:845-987-3906
Mailing Address - Fax:845-987-5979
Practice Address - Street 1:255 LAFAYETTE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-4812
Practice Address - Country:US
Practice Address - Phone:845-987-3906
Practice Address - Fax:845-987-5979
Is Sole Proprietor?:No
Enumeration Date:2012-09-14
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY337003363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily