MEDICARE: KENNETH JAMES FEINGOLD LP

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	102L00000X	Psychoanalyst	000865	NY

General Provider Information

NPI Number	:	1841580008
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KENNETH JAMES FEINGOLD LP

Provider Business Mailing Address
First Line	:	123 FORT GREENE PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3490
Country	:	US
Telephone Number	:	917-251-6038
Fax Number	:	866-491-8591

Provider Business Practice Location Address
First Line	:	123 FORT GREENE PL
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11217-3490
Country	:	US
Telephone Number	:	917-251-6038
Fax Number	:	866-491-8591

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2011
Last Update Date	:	11/14/2024

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