Provider Demographics
NPI:1356375778
Name:FEIN, MICHAEL Z (DPM)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:Z
Last Name:FEIN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SCHOOL ST
Mailing Address - Street 2:
Mailing Address - City:BETHEL
Mailing Address - State:CT
Mailing Address - Zip Code:06801-1846
Mailing Address - Country:US
Mailing Address - Phone:203-743-7083
Mailing Address - Fax:
Practice Address - Street 1:8 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:BETHEL
Practice Address - State:CT
Practice Address - Zip Code:06801-1846
Practice Address - Country:US
Practice Address - Phone:203-743-7083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTP00307213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT480000266Medicare PIN
CT0510540001Medicare NSC
CT480000759Medicare PIN
CTT92455Medicare UPIN