Provider Demographics
NPI:1740269190
Name:FEINTECH, EDWIN RONALD (PHD PSYCHOLOGY)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:RONALD
Last Name:FEINTECH
Suffix:
Gender:M
Credentials:PHD PSYCHOLOGY
Other - Prefix:
Other - First Name:EDWIN
Other - Middle Name:R
Other - Last Name:FEINTECH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:15 GRAYSTONE RD
Mailing Address - Street 2:
Mailing Address - City:GRAY
Mailing Address - State:ME
Mailing Address - Zip Code:04039-7517
Mailing Address - Country:US
Mailing Address - Phone:207-415-5290
Mailing Address - Fax:
Practice Address - Street 1:15 GRAYSTONE RD
Practice Address - Street 2:
Practice Address - City:GRAY
Practice Address - State:ME
Practice Address - Zip Code:04039-7517
Practice Address - Country:US
Practice Address - Phone:207-415-2908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-13
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPS572103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical