Provider Demographics
NPI:1982872743
Name:FELLER, LAUREEN A (NP)
Entity Type:Individual
Prefix:
First Name:LAUREEN
Middle Name:A
Last Name:FELLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:158 N MAIN ST
Mailing Address - Street 2:PO BOX 299
Mailing Address - City:FLORIDA
Mailing Address - State:NY
Mailing Address - Zip Code:10921-1133
Mailing Address - Country:US
Mailing Address - Phone:845-651-1412
Mailing Address - Fax:845-651-1512
Practice Address - Street 1:60 DUNNING RD STE 1
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:NY
Practice Address - Zip Code:10940-2216
Practice Address - Country:US
Practice Address - Phone:845-344-4477
Practice Address - Fax:845-344-6072
Is Sole Proprietor?:No
Enumeration Date:2008-02-14
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF302823363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health