Provider Demographics
NPI:1215540737
Name:FEELEY, JOHN JOSEPH JR
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:JOSEPH
Last Name:FEELEY
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1009 SIGSBEE PL NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1842
Mailing Address - Country:US
Mailing Address - Phone:202-526-8754
Mailing Address - Fax:
Practice Address - Street 1:3505 LIVINGSTON RD
Practice Address - Street 2:
Practice Address - City:INDIAN HEAD
Practice Address - State:MD
Practice Address - Zip Code:20640-3200
Practice Address - Country:US
Practice Address - Phone:301-932-6610
Practice Address - Fax:301-870-3814
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist