Provider Demographics
NPI:1174692149
Name:FELSENFELD, RACHAEL ERICA (PSYD)
Entity type:Individual
Prefix:DR
First Name:RACHAEL
Middle Name:ERICA
Last Name:FELSENFELD
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WORLDS FAIR DR STE 206
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-1369
Mailing Address - Country:US
Mailing Address - Phone:917-674-7703
Mailing Address - Fax:
Practice Address - Street 1:2 WORLDS FAIR DR STE 206
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1369
Practice Address - Country:US
Practice Address - Phone:917-674-7703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016385-1103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02711833Medicaid
NY02711833Medicaid