Provider Demographics
NPI:1295483477
Name:FEIJOO, JOSE MANUEL
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:MANUEL
Last Name:FEIJOO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:KEARNY
Mailing Address - State:NJ
Mailing Address - Zip Code:07032-2885
Mailing Address - Country:US
Mailing Address - Phone:551-580-0130
Mailing Address - Fax:
Practice Address - Street 1:11 MAPLE ST
Practice Address - Street 2:
Practice Address - City:KEARNY
Practice Address - State:NJ
Practice Address - Zip Code:07032-2885
Practice Address - Country:US
Practice Address - Phone:551-580-0130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer