Provider Demographics
NPI:1497725154
Name:FEIN, AMNON (MD)
Entity Type:Individual
Prefix:DR
First Name:AMNON
Middle Name:
Last Name:FEIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:974 RT 45
Mailing Address - Street 2:SUITE 1000
Mailing Address - City:POMONA
Mailing Address - State:NY
Mailing Address - Zip Code:10970
Mailing Address - Country:US
Mailing Address - Phone:845-354-1113
Mailing Address - Fax:845-354-1813
Practice Address - Street 1:974 RT 45
Practice Address - Street 2:SUITE 1000
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970
Practice Address - Country:US
Practice Address - Phone:845-354-1113
Practice Address - Fax:845-354-1813
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY148171207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01399233Medicaid
NYWJD371Medicare PIN
NY74D361Medicare PIN
NY01399233Medicaid
NY74D36JD371Medicare PIN