Provider Demographics
NPI:1578539961
Name:FLH MEDICAL ,PC
Entity Type:Organization
Organization Name:FLH MEDICAL ,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:315-787-5322
Mailing Address - Street 1:1930 PRE EMPTION RD
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9641
Mailing Address - Country:US
Mailing Address - Phone:315-536-0086
Mailing Address - Fax:315-536-4107
Practice Address - Street 1:1930 PRE EMPTION RD
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-9641
Practice Address - Country:US
Practice Address - Phone:315-536-0086
Practice Address - Fax:315-536-4107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-24
Last Update Date:2011-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY202333207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01537466Medicaid
NY14189AMedicare ID - Type Unspecified
NY01537466Medicaid