Healthcare Provider Details

I. General information

NPI: 1679565659
Provider Name (Legal Business Name): WILLIAM J FEENEY MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

596 NEW LOUDON RD
LATHAM NY
12110-4024
US

IV. Provider business mailing address

PO BOX 11719
ALBANY NY
12211-0719
US

V. Phone/Fax

Practice location:
  • Phone: 518-782-7133
  • Fax:
Mailing address:
  • Phone: 518-389-1804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM J FEENEY
Title or Position: OWNER
Credential: MD
Phone: 518-782-7133