Provider Demographics
NPI:1568464808
Name:FEIT, ELLEN S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:S
Last Name:FEIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TURRET LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-1021
Mailing Address - Country:US
Mailing Address - Phone:516-496-2566
Mailing Address - Fax:
Practice Address - Street 1:SUNY - COLLEGE AT OLD WESTBURY
Practice Address - Street 2:STUDENT HEALTH SERVICE, ROOSEVENT HALL
Practice Address - City:OLD WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11568-0210
Practice Address - Country:US
Practice Address - Phone:516-876-3250
Practice Address - Fax:516-876-3142
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY191428207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF79948Medicare UPIN