MEDICARE: JOSEPH G. FEGHALI, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261Q00000X	Clinic/Center	141640	NY

General Provider Information

NPI Number	:	1730257023
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JOSEPH G. FEGHALI, M.D., P.C.

Provider Business Mailing Address
First Line	:	182 E 210TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2411
Country	:	US
Telephone Number	:	718-881-3277
Fax Number	:	718-881-4911

Provider Business Practice Location Address
First Line	:	182 E 210TH ST
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10467-2411
Country	:	US
Telephone Number	:	718-881-3277
Fax Number	:	718-881-4911

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOSEPH G. FEGHALI
Credential	:	M.D.
Telephone Number	:	718-881-3277

Provider Enumeration Date	:	12/03/2006
Last Update Date	:	09/14/2011

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