Provider Demographics
NPI:1053584706
Name:FELDMAN, AMY J (PSYD)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:J
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 WILLIS AVENUE
Mailing Address - Street 2:MINEOLA
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:11753
Mailing Address - Country:US
Mailing Address - Phone:516-620-2075
Mailing Address - Fax:
Practice Address - Street 1:147 WILLIS AVE
Practice Address - Street 2:
Practice Address - City:MINEOLA
Practice Address - State:NY
Practice Address - Zip Code:11501-2660
Practice Address - Country:US
Practice Address - Phone:516-620-2075
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-02
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016139103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent