Healthcare Provider Details

I. General information

NPI: 1215174644
Provider Name (Legal Business Name): FLH MEDICAL, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2009
Last Update Date: 07/05/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1930 PRE EMPTION RD
PENN YAN NY
14527-9641
US

IV. Provider business mailing address

196 NORTH ST
GENEVA NY
14456-1651
US

V. Phone/Fax

Practice location:
  • Phone: 315-230-5646
  • Fax: 315-230-5645
Mailing address:
  • Phone: 315-230-5646
  • Fax: 315-230-5645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1963311
License Number StateNY

VIII. Authorized Official

Name: JASON FEINBERG
Title or Position: OWNER
Credential: MD
Phone: 315-787-4150