Healthcare Provider Details

I. General information

NPI: 1134111586
Provider Name (Legal Business Name): DR. GEORGE FEINBAUM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/20/2005
Last Update Date: 03/29/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

934 MANHATTAN AVE
BROOKLYN NY
11222-5928
US

IV. Provider business mailing address

934 MANHATTAN AVE
BROOKLYN NY
11222-5928
US

V. Phone/Fax

Practice location:
  • Phone: 718-389-8585
  • Fax: 718-389-2378
Mailing address:
  • Phone: 718-389-8585
  • Fax: 718-389-2378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number120659
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number120659
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: