Provider Demographics
NPI:1881672533
Name:FEIN, ALLEN LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:ALLEN
Middle Name:LAWRENCE
Last Name:FEIN
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 1:45 RESEARCH WAY STE 105
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-6401
Mailing Address - Country:US
Mailing Address - Phone:631-675-2125
Mailing Address - Fax:631-675-2624
Practice Address - Street 1:365 COUNTY ROAD 39A UNIT 11
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968
Practice Address - Country:US
Practice Address - Phone:631-283-6446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2018-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYA2000404207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01593668Medicaid
P2130294OtherOXFORD HEALTHPLANS
NYAK46204AOtherMDNY
P374141OtherOXFORD
38484OtherCIGNA
54733OtherVYTRA HEALTH PLANS
711379OtherHARVARD PILGRIM HEALTHCAR
88573OtherVYTRA HEALTH PLANS
NYAK46204AOtherMDNY
F36048Medicare UPIN
NY01593668Medicaid