Healthcare Provider Details

I. General information

NPI: 1700779048
Provider Name (Legal Business Name): MICHAEL Z FEIN DPM PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/03/2025
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 SCHOOL ST
BETHEL CT
06801-1877
US

IV. Provider business mailing address

PO BOX 825159
PHILADELPHIA PA
19182-5159
US

V. Phone/Fax

Practice location:
  • Phone: 203-743-7083
  • Fax:
Mailing address:
  • Phone: 866-626-1540
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: ROSALIE KREIGHBAUM
Title or Position: REGIONAL CREDENTIALING SPECIALIST
Credential:
Phone: 314-909-1920