Healthcare Provider Details

I. General information

NPI: 1740506567
Provider Name (Legal Business Name): JONATHAN A FEISTMANN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2010
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 E 9TH ST
NEW YORK NY
10003-5944
US

IV. Provider business mailing address

20 E 9TH ST
NEW YORK NY
10003-5944
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 A FEISTMANN
Title or Position: OWNER
Credential: M.D.
Phone: 917-587-7672