Provider Demographics
NPI:1326052168
Name:FESTIN, FE ERLITA D (MD)
Entity Type:Individual
Prefix:
First Name:FE ERLITA
Middle Name:D
Last Name:FESTIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:FE ERLITA
Other - Middle Name:R
Other - Last Name:DIOLAZO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11 CHRISTINA DR
Mailing Address - Street 2:
Mailing Address - City:NORTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02356-1132
Mailing Address - Country:US
Mailing Address - Phone:508-230-8830
Mailing Address - Fax:
Practice Address - Street 1:940 BELMONT ST
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5596
Practice Address - Country:US
Practice Address - Phone:774-826-1393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA704192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
777070OtherTUFTS
MA15-02228OtherEVERCARE
MA3045790Medicaid
MAJ08405OtherBLUE SHIELD OF MA
MA260022256Medicare PIN
MA15-02228OtherEVERCARE
MAJ08405Medicare PIN