Provider Demographics
NPI:1477586303
Name:FEOLA, JEFFREY A (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:FEOLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:450 CLARKSON AVE
Mailing Address - Street 2:BOX 1203
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2056
Mailing Address - Country:US
Mailing Address - Phone:718-270-8867
Mailing Address - Fax:718-270-1794
Practice Address - Street 1:450 CLARKSON AVE
Practice Address - Street 2:BOX 1203
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2056
Practice Address - Country:US
Practice Address - Phone:718-270-2025
Practice Address - Fax:718-270-4617
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2021-09-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2145022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry