Healthcare Provider Details

I. General information

NPI: 1578539961
Provider Name (Legal Business Name): FLH MEDICAL ,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 06/24/2011
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

1930 PRE EMPTION RD
PENN YAN NY
14527-9641
US

V. Phone/Fax

Practice location:
  • Phone: 315-536-0086
  • Fax: 315-536-4107
Mailing address:
  • Phone: 315-536-0086
  • Fax: 315-536-4107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number202333
License Number StateNY

VIII. Authorized Official

Name: DR. JASON FEINBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 315-787-5322