Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | NJ10344 | NJ |
NPI | 1033151006 |
---|---|
Provider Name | Dr. Robert D Feldman |
First Address | Red Bank, NJ 07701-1727 |
Second Address | Red Bank, NJ 07701-1727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0555703 | (05) | NJ |