Healthcare Provider Details

I. General information

NPI: 1649347378
Provider Name (Legal Business Name): JENNIFER L FEINGOLD LIC. AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3900 CITY AVE #D1109
PHILADELPHIA PA
19131-2908
US

IV. Provider business mailing address

3900 CITY AVE #D1109
PHILADELPHIA PA
19131-2908
US

V. Phone/Fax

Practice location:
  • Phone: 267-275-0135
  • Fax:
Mailing address:
  • Phone: 267-275-0135
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number207377
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: