Provider Demographics
NPI:1134163173
Name:DWORKIN, FELICIA FAITH (MD)
Entity type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:FAITH
Last Name:DWORKIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4209 28TH ST # CN-48
Mailing Address - Street 2:
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-4130
Mailing Address - Country:US
Mailing Address - Phone:347-396-6299
Mailing Address - Fax:347-396-6367
Practice Address - Street 1:295 FLATBUSH AVENUE EXT FL 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11201-3001
Practice Address - Country:US
Practice Address - Phone:347-396-6299
Practice Address - Fax:347-396-6367
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY175712207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
F86578Medicare UPIN
NY0105BDMedicare ID - Type UnspecifiedGHI
NY93S321Medicare ID - Type UnspecifiedEMPIRE
NY0105BCMedicare ID - Type UnspecifiedGHI