Provider Demographics
NPI:1588757025
Name:FELDMAN-WINTER, LORI BETH
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:BETH
Last Name:FELDMAN-WINTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 COOPER PLZ
Mailing Address - Street 2:SUITE 502
Mailing Address - City:CAMDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08103-1438
Mailing Address - Country:US
Mailing Address - Phone:856-968-7433
Mailing Address - Fax:
Practice Address - Street 1:3 COOPER PLZ
Practice Address - Street 2:SUITE 200
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08103-1438
Practice Address - Country:US
Practice Address - Phone:856-342-2472
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2016-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA052411208000000X, 2080A0000X
PAMD039798E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1262602Medicaid
NJ3404101OtherAETNA
NJ1925448OtherUNITED HEALTHCARE
NJ010002414OtherAMERICHOICE
NJ0863212OtherCIGNA
NJ3404081OtherAETNA
NJ3K5965OtherHEALTHNET
NJ15935OtherUNIVERSITY HEALTH PLAN
NJ60004298OtherHORIZON NJ HEALTH
NJ60004295OtherHORIZON NJ HEALTH
NJ60004297OtherHORIZON NJ HEALTH
NJ670385OtherPA BS HIGHMARK
NJ3404088OtherAETNA
NJ670385OtherAMERIHEALTH PO/ PA BS
NJP3112504OtherOXFORD
NJ3404088OtherAETNA
NJ0503548000Medicare PIN
NJ670385 MB5Medicare PIN