Provider Demographics
NPI:1386963817
Name:FELDSTEIN, FRED (DC)
Entity type:Individual
Prefix:DR
First Name:FRED
Middle Name:
Last Name:FELDSTEIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 KINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-4332
Mailing Address - Country:US
Mailing Address - Phone:718-221-3999
Mailing Address - Fax:718-221-2482
Practice Address - Street 1:372 KINGSTON AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-4332
Practice Address - Country:US
Practice Address - Phone:718-221-3999
Practice Address - Fax:718-221-2482
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-24
Last Update Date:2010-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005689111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor