Provider Demographics
NPI:1598850109
Name:FEINBERG, BRUCE (OD)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:
Last Name:FEINBERG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N FEATHERING LN
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-1908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:319 W STATE ST
Practice Address - Street 2:
Practice Address - City:MEDIA
Practice Address - State:PA
Practice Address - Zip Code:19063-2615
Practice Address - Country:US
Practice Address - Phone:619-566-1227
Practice Address - Fax:610-566-6888
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOET008751152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00473439OtherRAILROAD MEDICARE
PAP00473439OtherRAILROAD MEDICARE
PAT30648Medicare UPIN