Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223P0300X | Periodontist | 051281 | NY |
N | 1223P0300X | Periodontist | DS037447 | PA |
Y | 1223P0300X | Periodontist | G1-0001261 | DE |
NPI | 1134316144 |
---|---|
Provider Name | Dr. Jeffrey Evan Felzer |
First Address | Philadelphia, PA 19106-1866 |
Second Address | Wilmington, DE 19808-2147 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2007 |
Last Update Date | 23/02/2009 |