MEDICARE: DR. DAVID ALLEN FEINGOLD MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2081P0010X	Pediatric Rehabilitation Medicine Physician	035179	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	010035179CT03	OTHER	CT	BCBS
3	0187241	OTHER	CT	MASS. HEALTH

General Provider Information

NPI Number	:	1356346779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ALLEN FEINGOLD MD

Provider Business Mailing Address
First Line	:	35 JOLLEY DR
Second Line	:	STE 101
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-4228
Country	:	US
Telephone Number	:	860-243-3434
Fax Number	:	860-243-0208

Provider Business Practice Location Address
First Line	:	701 COTTAGE GROVE RD
Second Line	:	STE F120
City	:	BLOOMFIELD
State	:	CT
Zip	:	06002-3095
Country	:	US
Telephone Number	:	860-243-3434
Fax Number	:	860-243-0208

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	04/24/2018

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