Healthcare Provider Details

I. General information

NPI: 1619112943
Provider Name (Legal Business Name): JONATHAN A. FEISTMANN, MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2008
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 E 19TH ST
NEW YORK NY
10003-9605
US

IV. Provider business mailing address

112 E 19TH ST
NEW YORK NY
10003-9605
US

V. Phone/Fax

Practice location:
  • Phone: 212-203-0999
  • Fax: 212-202-4884
Mailing address:
  • Phone: 212-203-0999
  • Fax: 212-202-4884

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number240088
License Number StateNY

VIII. Authorized Official

Name: JONATHAN AMIR FEISTMANN
Title or Position: PRESIDENT
Credential:
Phone: 212-203-0999