Provider Demographics
NPI:1104640630
Name:FELICH, ARTUR
Entity type:Individual
Prefix:
First Name:ARTUR
Middle Name:
Last Name:FELICH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 FERONIA WAY APT 2B
Mailing Address - Street 2:
Mailing Address - City:RUTHERFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07070-2078
Mailing Address - Country:US
Mailing Address - Phone:718-710-8084
Mailing Address - Fax:
Practice Address - Street 1:129 W 27TH ST UNIT 801
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6206
Practice Address - Country:US
Practice Address - Phone:718-710-8084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-12
Last Update Date:2024-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028150225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist