Healthcare Provider Details

I. General information

NPI: 1790534162
Provider Name (Legal Business Name): JULIANNA FEIGENBAUM MBA, LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 E BETHPAGE RD
PLAINVIEW NY
11803-4228
US

IV. Provider business mailing address

5 ELMHURST DR
OLD WESTBURY NY
11568-1007
US

V. Phone/Fax

Practice location:
  • Phone: 800-679-3609
  • Fax:
Mailing address:
  • Phone: 516-606-2485
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number123192
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: