Provider Demographics
NPI:1023093598
Name:FEENEY, ROBERT A (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:A
Last Name:FEENEY
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 1:103 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-5123
Mailing Address - Country:US
Mailing Address - Phone:315-336-6800
Mailing Address - Fax:315-336-5336
Practice Address - Street 1:103 W COURT ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5123
Practice Address - Country:US
Practice Address - Phone:315-336-6800
Practice Address - Fax:315-336-5336
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-07
Last Update Date:2012-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129973207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY444112283OtherRR MEDICARE
NY0023900OtherBLUE CROSS
NY001121099OtherGHI
NY10069553OtherCDPHP
NY115056OtherMVP
NM0030500OtherEMPIRE
NY00551280Medicaid
NY0023900OtherBLUE CROSS
NY56439AMedicare ID - Type Unspecified