Provider Demographics
NPI:1639150469
Name:FEYGINA, ALLA (MD)
Entity Type:Individual
Prefix:
First Name:ALLA
Middle Name:
Last Name:FEYGINA
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 1:55 SHARON ANN LN
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-6034
Mailing Address - Country:US
Mailing Address - Phone:617-549-5669
Mailing Address - Fax:617-607-7543
Practice Address - Street 1:55 SHARON ANN LN
Practice Address - Street 2:
Practice Address - City:EAST FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02536-6034
Practice Address - Country:US
Practice Address - Phone:617-549-5669
Practice Address - Fax:617-607-7543
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA153423207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3181154Medicaid
MAA23456Medicare ID - Type Unspecified
MA3181154Medicaid