Provider Demographics
NPI:1972889616
Name:FEINER, ADAM JOSEPH (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:JOSEPH
Last Name:FEINER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:DR
Other - First Name:ADAM
Other - Middle Name:J
Other - Last Name:FEINER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:4700 WISSAHICKON AVE
Mailing Address - Street 2:BUILDING D, SUITE 118
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4248
Mailing Address - Country:US
Mailing Address - Phone:267-597-3677
Mailing Address - Fax:
Practice Address - Street 1:4700 WISSAHICKON AVE
Practice Address - Street 2:BUILDING D, SUITE 118
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4248
Practice Address - Country:US
Practice Address - Phone:267-597-3677
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017110103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical