Provider Demographics
NPI:1801297775
Name:FEILER, MARY (PNP)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:FEILER
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Mailing Address - Street 1:3920 VETERANS MEMORIAL HWY STE 8
Mailing Address - Street 2:
Mailing Address - City:BOHEMIA
Mailing Address - State:NY
Mailing Address - Zip Code:11716-1074
Mailing Address - Country:US
Mailing Address - Phone:631-563-8190
Mailing Address - Fax:631-563-8194
Practice Address - Street 1:3920 VETERANS MEMORIAL HWY STE 8
Practice Address - Street 2:
Practice Address - City:BOHEMIA
Practice Address - State:NY
Practice Address - Zip Code:11716-1074
Practice Address - Country:US
Practice Address - Phone:631-563-8190
Practice Address - Fax:631-563-8194
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-10
Last Update Date:2023-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY382476208000000X
NY382476-1N363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics