Provider Demographics
NPI:1437324803
Name:MICHAEL Z FEIN DPM PC
Entity Type:Organization
Organization Name:MICHAEL Z FEIN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DPM/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:FEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-743-7083
Mailing Address - Street 1:714 CHASE PKWY
Mailing Address - Street 2:SUITE 4
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3012
Mailing Address - Country:US
Mailing Address - Phone:203-755-0489
Mailing Address - Fax:203-755-7523
Practice Address - Street 1:714 CHASE PKWY
Practice Address - Street 2:SUITE 4
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3012
Practice Address - Country:US
Practice Address - Phone:203-755-0489
Practice Address - Fax:203-755-7523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00548213E00000X
332B00000X
CT548335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
No335E00000XSuppliersProsthetic/Orthotic SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT004139269Medicaid
CTU02747Medicare UPIN
CT004139269Medicaid