1194704627 NPI number — DORON FELDMAN MD

Table of content: DORON FELDMAN MD (NPI 1194704627)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194704627 NPI number — DORON FELDMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELDMAN
Provider First Name:
DORON
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194704627
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
219 BRYANT ST
Provider Second Line Business Mailing Address:
CGF ANESTHESIA ASSOCIATES PC
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14222-2006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-878-7444
Provider Business Mailing Address Fax Number:
716-878-7316

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
219 BRYANT ST.
Provider Second Line Business Practice Location Address:
WOMEN & CHILDREN'S HOSPITAL OF BUFFALO
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14222-2006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-878-7701
Provider Business Practice Location Address Fax Number:
716-878-7316
Provider Enumeration Date:
01/12/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , with the licence number:  1916121 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 174400000X , with the licence number: MD050938L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 01495867 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".