Provider Demographics
NPI:1881781300
Name:FELDMANN, AMY NICOLE (MPT)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:NICOLE
Last Name:FELDMANN
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 OLD EAGLE SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:PA
Mailing Address - Zip Code:19087-2006
Mailing Address - Country:US
Mailing Address - Phone:610-225-2451
Mailing Address - Fax:610-964-6166
Practice Address - Street 1:445 OLD EAGLE SCHOOL RD
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:PA
Practice Address - Zip Code:19087-2006
Practice Address - Country:US
Practice Address - Phone:610-225-2451
Practice Address - Fax:610-964-6166
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT011743L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232880000OtherINDEPENDENCE BLUE CROSS
PAMA1652217OtherHIGHMARK BLUE SHIELD
PA250651OtherHEALTH AMER/HEALTH ASSUR.
PA396749Medicare ID - Type UnspecifiedMEDICARE