Provider Demographics
NPI:1417152455
Name:FEINBERG, MORRIS ELIEZER (DMD)
Entity Type:Individual
Prefix:DR
First Name:MORRIS
Middle Name:ELIEZER
Last Name:FEINBERG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:M
Other - Middle Name:
Other - Last Name:FEINBERG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD PC
Mailing Address - Street 1:304 W BAY PLZ
Mailing Address - Street 2:
Mailing Address - City:PLATTSBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12901-1787
Mailing Address - Country:US
Mailing Address - Phone:518-825-0025
Mailing Address - Fax:518-825-0029
Practice Address - Street 1:304 W BAY PLZ
Practice Address - Street 2:
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901-1787
Practice Address - Country:US
Practice Address - Phone:518-825-0025
Practice Address - Fax:518-825-0029
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-19
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045345-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01535226Medicaid