Provider Demographics
NPI:1083716500
Name:FEGHALI, JOSEPH G (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:G
Last Name:FEGHALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WHITE PLAINS RD FL 4
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5139
Mailing Address - Country:US
Mailing Address - Phone:914-984-2546
Mailing Address - Fax:
Practice Address - Street 1:1200 WATERS PL STE 110
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-0371
Practice Address - Country:US
Practice Address - Phone:718-863-4366
Practice Address - Fax:718-863-9743
Is Sole Proprietor?:No
Enumeration Date:2006-09-04
Last Update Date:2019-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY141640207YX0901X, 207Y00000X
NY14000010120237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY58F031Medicare ID - Type Unspecified
NY58F032Medicare ID - Type Unspecified