Provider Demographics
NPI:1841580008
Name:FEINGOLD, KENNETH JAMES (LP)
Entity type:Individual
Prefix:
First Name:KENNETH
Middle Name:JAMES
Last Name:FEINGOLD
Suffix:
Gender:M
Credentials:LP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 FORT GREENE PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3490
Mailing Address - Country:US
Mailing Address - Phone:917-251-6038
Mailing Address - Fax:866-491-8591
Practice Address - Street 1:123 FORT GREENE PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3490
Practice Address - Country:US
Practice Address - Phone:917-251-6038
Practice Address - Fax:866-491-8591
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-08
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000865102L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst