Individual
BLAKE SAMUEL FELDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGNP
Contact information
Practice address
3900 WOODLAND AVE, PHILADELPHIA, PA 19104-4551
(215) 823-5800
(215) 823-4234
Mailing address
1541 DICKINSON ST, PHILADELPHIA, PA 19146-4848
(954) 873-9953
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP025161
PA
Other
Enumeration date
04/08/2022
Last updated
04/07/2023
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