Provider Demographics
NPI:1841463098
Name:FEIN, JORDANA G (MD, MS)
Entity type:Individual
Prefix:DR
First Name:JORDANA
Middle Name:G
Last Name:FEIN
Suffix:
Gender:F
Credentials:MD, MS
Other - Prefix:DR
Other - First Name:JORDANA
Other - Middle Name:FIRESTONE
Other - Last Name:GOREN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, MS
Mailing Address - Street 1:7501 GREENWAY CENTER DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-3514
Mailing Address - Country:US
Mailing Address - Phone:301-474-4679
Mailing Address - Fax:301-474-7182
Practice Address - Street 1:10530 LINDEN LAKE PLZ STE 305
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20109-6434
Practice Address - Country:US
Practice Address - Phone:703-257-9270
Practice Address - Fax:703-257-9284
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD042859207W00000X
VA0101256076207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1848463098Medicaid
DC366222Y2FMedicare PIN