Provider Demographics
NPI:1992026280
Name:MARC FEINGOLD MD LLC
Entity Type:Organization
Organization Name:MARC FEINGOLD MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:732-536-8008
Mailing Address - Street 1:38 PINE ST
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1833
Mailing Address - Country:US
Mailing Address - Phone:732-536-8008
Mailing Address - Fax:
Practice Address - Street 1:410 BRIDGE PLAZA DR
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-1735
Practice Address - Country:US
Practice Address - Phone:732-536-8008
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA08475500207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ25MA08475500OtherNJ LICENSE