Provider Demographics
NPI:1184171365
Name:MARIELLE FEINGOLD FAMILY CHIROPRACTIC PLLC
Entity type:Organization
Organization Name:MARIELLE FEINGOLD FAMILY CHIROPRACTIC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEINGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:631-804-5874
Mailing Address - Street 1:5 TALMAN PL
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-7130
Mailing Address - Country:US
Mailing Address - Phone:631-804-5874
Mailing Address - Fax:
Practice Address - Street 1:5 TALMAN PL
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-7130
Practice Address - Country:US
Practice Address - Phone:631-804-5874
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty