Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YM0800X | Mental Health Counselor |
NPI | 1003266180 |
---|---|
Provider Name | Keinan Feldman |
First Address | Brooklyn, NY 11201-3628 |
Second Address | Brooklyn, NY 11201-3628 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2016 |
Last Update Date | 20/06/2016 |