Provider Demographics
NPI:1174830855
Name:FEINERMAN, AVIGAL (MS)
Entity Type:Individual
Prefix:MRS
First Name:AVIGAL
Middle Name:
Last Name:FEINERMAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-4625
Mailing Address - Country:US
Mailing Address - Phone:718-868-3787
Mailing Address - Fax:
Practice Address - Street 1:13844 JEWEL AVE
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11367-1933
Practice Address - Country:US
Practice Address - Phone:718-263-3455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004208101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health