Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | CPED2889 | DE |
NPI | 1538498514 |
---|---|
Provider Name | Mr. Michael Feder |
First Address | Rego Park, NY 11374-2653 |
Second Address | Brooklyn, NY 11235-5607 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2009 |
Last Update Date | 21/12/2009 |