Provider Demographics
NPI:1972556454
Name:FEINER, LAUREL A (MD)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:A
Last Name:FEINER
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 1:40 BEY LEA RD
Mailing Address - Street 2:#B103
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-2900
Mailing Address - Country:US
Mailing Address - Phone:732-349-1012
Mailing Address - Fax:732-349-1082
Practice Address - Street 1:40 BEY LEA RD
Practice Address - Street 2:#B103
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-2900
Practice Address - Country:US
Practice Address - Phone:732-349-1012
Practice Address - Fax:732-349-1082
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05744100207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ065252OtherMEDICARE PTAN
NJ1972556454OtherPERSONAL MEDICARE PIN
NJ5477107Medicaid
NJ0970460001Medicare NSC
NJ1659550606Medicare PIN
NJE12838Medicare UPIN