Healthcare Provider Details

I. General information

NPI: 1639150469
Provider Name (Legal Business Name): ALLA FEYGINA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 02/25/2022
Certification Date: 02/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 SHARON ANN LN
EAST FALMOUTH MA
02536-6034
US

IV. Provider business mailing address

55 SHARON ANN LN
EAST FALMOUTH MA
02536-6034
US

V. Phone/Fax

Practice location:
  • Phone: 617-549-5669
  • Fax: 617-607-7543
Mailing address:
  • Phone: 617-549-5669
  • Fax: 617-607-7543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number153423
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: