Provider Demographics
NPI:1083613483
Name:FEENEY, JOHN P (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:FEENEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:835 PULASKI HWY
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1240
Mailing Address - Country:US
Mailing Address - Phone:302-328-0200
Mailing Address - Fax:302-328-9088
Practice Address - Street 1:835 PULASKI HWY
Practice Address - Street 2:
Practice Address - City:BEAR
Practice Address - State:DE
Practice Address - Zip Code:19701-1240
Practice Address - Country:US
Practice Address - Phone:302-328-0200
Practice Address - Fax:302-328-9088
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000127111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1433085OtherPA BLUE CROSS
CT3713766OtherAETNA
DE0081167000Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
DEUO1968Medicare UPIN