Provider Demographics
NPI:1356389399
Name:FEYGIN, LAZAR (MD)
Entity type:Individual
Prefix:DR
First Name:LAZAR
Middle Name:
Last Name:FEYGIN
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 1:198 FOSTER AVE
Mailing Address - Street 2:SUITE 1B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11230-1133
Mailing Address - Country:US
Mailing Address - Phone:718-854-3005
Mailing Address - Fax:718-854-9803
Practice Address - Street 1:198 FOSTER AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11230-2133
Practice Address - Country:US
Practice Address - Phone:718-854-3005
Practice Address - Fax:718-854-9803
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212904207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01905751Medicaid
NYG43771Medicare UPIN
NY01905751Medicaid