MEDICARE: STEVEN FESTA 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	2085R0202X	Diagnostic Radiology Physician	25MA06998900	MA

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

General Provider Information

NPI Number	:	1467433813
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN FESTA MD

Provider Business Mailing Address
First Line	:	PO BOX 9135
Second Line	:	ATT:SHARON SILVA
City	:	BROOKLINE
State	:	MA
Zip	:	02446-9135
Country	:	US
Telephone Number	:	800-927-0002
Fax Number	:	603-893-8886

Provider Business Practice Location Address
First Line	:	220 HAMBURG TPKE
Second Line	:
City	:	WAYNE
State	:	NJ
Zip	:	07470-2110
Country	:	US
Telephone Number	:	973-904-0404
Fax Number	:

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	12/14/2009

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