Provider Demographics
NPI:1720184021
Name:FEINBERG, MICHAEL ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ALLEN
Last Name:FEINBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 CHASE PKWY
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-3939
Mailing Address - Country:US
Mailing Address - Phone:203-756-7203
Mailing Address - Fax:203-756-3628
Practice Address - Street 1:714 CHASE PKWY
Practice Address - Street 2:SUITE 6
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-3939
Practice Address - Country:US
Practice Address - Phone:203-756-7203
Practice Address - Fax:203-756-3628
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT18329207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001183292Medicaid
010018329CT01OtherBCBS
010018329CT01OtherBCBS
110000832Medicare ID - Type Unspecified