Basic Information
Provider Information | |||||||||
NPI: | 1538158613 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | FELD | ||||||||
FirstName: | STEVEN | ||||||||
MiddleName: | M | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 3 COOPER PLAZA | ||||||||
Address2: | SUITE 502 | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 08103 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8569636888 | ||||||||
FaxNumber: | 8569688499 | ||||||||
Practice Location | |||||||||
Address1: | ONE COOPER PLAZA | ||||||||
Address2: | DORRANCE BLDG ROOM 623 | ||||||||
City: | CAMDEN | ||||||||
State: | NJ | ||||||||
PostalCode: | 08103 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8563422491 | ||||||||
FaxNumber: | 8563427023 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 10/20/2005 | ||||||||
LastUpdateDate: | 04/05/2010 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | 25MA03837100 | NJ | Y |   | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
ID | Type | State | Issuer | Description | 010045991 | 01 | NJ | AMERICHOICE | OTHER | 0104627000 | 01 | NJ | AMERIHEALTH/KEYSTONE/IBC | OTHER | 1665853 | 01 | NJ | AETNA | OTHER | 1689304 | 05 | NJ |   | MEDICAID | 0951412 | 01 | NJ | CIGNA | OTHER | 1770448 | 01 | NJ | AETNA | OTHER | 60035048 | 01 | NJ | HORIZON NJ HEALTH | OTHER |