Provider Demographics
NPI:1629046008
Name:FELIX, NANCY A (MD)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:A
Last Name:FELIX
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 1:113 HOLLAND AVE
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3410
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:113 HOLLAND AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3410
Practice Address - Country:US
Practice Address - Phone:518-626-6530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2016-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD14943207X00000X
FLME88385207X00000X
NY226086207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAP00154542OtherRAILROAD MEDICARE
GA456521OtherBCBS
GA10063733OtherAMERIGROUP MEDICAID HMO
GA603978500OtherFEDERAL WORKERS COMP
GA336666021CMedicaid
GA343107OtherWELLCARE MEDICAID HMO
FL57797OtherBCBS
GA336666021BMedicaid
GA336666021DMedicaid
GAF88684Medicare UPIN
GA20NCCGLMedicare ID - Type Unspecified
GA336666021CMedicaid