Provider Demographics
NPI:1952973786
Name:ADAM FELLINE, DMD
Entity Type:Organization
Organization Name:ADAM FELLINE, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:FELLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:646-270-5152
Mailing Address - Street 1:1987 CYNTHIA LN
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-5111
Mailing Address - Country:US
Mailing Address - Phone:646-270-5152
Mailing Address - Fax:
Practice Address - Street 1:801 MOTOR PKWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5256
Practice Address - Country:US
Practice Address - Phone:631-348-1501
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-12
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty