Provider Demographics
NPI:1811059108
Name:FEINGOLD, BRIAN D (MD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:D
Last Name:FEINGOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:444 COMMUNITY DRIVE
Mailing Address - Street 2:305A
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030
Mailing Address - Country:US
Mailing Address - Phone:516-365-1092
Mailing Address - Fax:516-365-5674
Practice Address - Street 1:2001 MARCUS AVENUE
Practice Address - Street 2:SUITE N100
Practice Address - City:LAKE SUCCESS
Practice Address - State:NY
Practice Address - Zip Code:11042
Practice Address - Country:US
Practice Address - Phone:516-365-1092
Practice Address - Fax:516-365-5674
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY177128NY207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
31N611Medicare ID - Type Unspecified
E69769Medicare UPIN