Provider Demographics
NPI:1942485834
Name:FELDMAN, BORIS SHEYLIKOVICH (SA-C)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:SHEYLIKOVICH
Last Name:FELDMAN
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13743 LAMBERTINA PL
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-5414
Mailing Address - Country:US
Mailing Address - Phone:301-545-1182
Mailing Address - Fax:301-545-1182
Practice Address - Street 1:13743 LAMBERTINA PL
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-5414
Practice Address - Country:US
Practice Address - Phone:301-545-1182
Practice Address - Fax:301-545-1182
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant