Provider Demographics
NPI:1508099870
Name:MARINA J. FEYGIN MEDICAL P.C.
Entity Type:Organization
Organization Name:MARINA J. FEYGIN MEDICAL P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRY
Authorized Official - Prefix:
Authorized Official - First Name:MARINA
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEYGIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-597-2206
Mailing Address - Street 1:2815 OCEAN PKWY
Mailing Address - Street 2:SUITE L1
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7839
Mailing Address - Country:US
Mailing Address - Phone:718-891-3005
Mailing Address - Fax:781-891-3007
Practice Address - Street 1:2815 OCEAN PKWY
Practice Address - Street 2:SUITE L1
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7839
Practice Address - Country:US
Practice Address - Phone:718-891-3005
Practice Address - Fax:781-891-3007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-02
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY216924174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02081074Medicaid
P2129711OtherOXFORD
P2129711OtherOXFORD