Provider Demographics
NPI:1760565220
Name:FEIFER, ELIZABETH (MSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:FEIFER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:580 SUNRISE HWY
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON,
Mailing Address - State:NY
Mailing Address - Zip Code:11704
Mailing Address - Country:US
Mailing Address - Phone:631-321-0011
Mailing Address - Fax:631-321-6140
Practice Address - Street 1:580 SUNRISE HWY
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-6003
Practice Address - Country:US
Practice Address - Phone:631-321-0011
Practice Address - Fax:631-321-6140
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0207851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
P1068793OtherOXFORD HEALTH
0892376OtherAETNA HEALTH
7401601OtherGHI
IP094006OtherMAGELLAN HEALTH
7401601OtherGHI