Provider Demographics
NPI:1164401733
Name:FELIX, DAVID JOSE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JOSE
Last Name:FELIX
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 1:55 E END AVE
Mailing Address - Street 2:APARTMENT 7D
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-7928
Mailing Address - Country:US
Mailing Address - Phone:212-744-0482
Mailing Address - Fax:
Practice Address - Street 1:161 MADISON AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5421
Practice Address - Country:US
Practice Address - Phone:212-213-1777
Practice Address - Fax:212-213-0752
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY211564-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02080308Medicaid
NYG76612Medicare UPIN
NY38N331Medicare ID - Type Unspecified