Healthcare Provider Details

I. General information

NPI: 1871220244
Provider Name (Legal Business Name): SHAINA R FEIFER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2022
Last Update Date: 08/04/2022
Certification Date: 08/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MICHAL 9 APT 5
JERUSALEM ISRAEL
9736508
IL

IV. Provider business mailing address

3475 SHANNON RD
CLEVELAND OH
44118-1924
US

V. Phone/Fax

Practice location:
  • Phone: 516-340-3224
  • Fax:
Mailing address:
  • Phone: 516-340-3224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number25796
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: