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Organization
MARK R FELDMAN MD PC
Active
Organization
MARK R FELDMAN MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK R FELDMAN MD (OWNER)
(845) 338-0599
Entity
Organization
Contact information
Practice address
192 PINE ST, KINGSTON, NY 12401-4528
(845) 338-0599
(845) 338-4266
Mailing address
192 PINE ST, KINGSTON, NY 12401-4528
(845) 338-0599
(845) 338-4266
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
127248
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00470860
—
NY
01
—
294981
MEDICARE ID-TYPE UNSPECIFIED
NY
01
—
A300001588
MEDICARE PTAN
NY
Enumeration date
01/10/2012
Last updated
01/10/2012
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