Provider Demographics
NPI:1740564574
Name:DONALD B. FEINSOD, M.D.,P.C.
Entity Type:Organization
Organization Name:DONALD B. FEINSOD, M.D.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:FEINSOD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-374-4422
Mailing Address - Street 1:1605 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1534
Mailing Address - Country:US
Mailing Address - Phone:516-374-4422
Mailing Address - Fax:516-374-3454
Practice Address - Street 1:1605 BROADWAY
Practice Address - Street 2:
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1534
Practice Address - Country:US
Practice Address - Phone:516-374-4422
Practice Address - Fax:516-374-3454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-28
Last Update Date:2011-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118762207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYB17320Medicare UPIN