Healthcare Provider Details

I. General information

NPI: 1215074257
Provider Name (Legal Business Name): ADRIANA FEDER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 GUSTAVE L LEVY PL BOX 1217
NEW YORK NY
10029-6500
US

IV. Provider business mailing address

1 GUSTAVE L LEVY PL # 1230
NEW YORK NY
10029-6504
US

V. Phone/Fax

Practice location:
  • Phone: 212-241-1563
  • Fax: 212-824-2302
Mailing address:
  • Phone: 212-241-8462
  • Fax: 212-241-3381

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number209439
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: