MEDICARE: DAF MEDICAL ASSOCIATES INC

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	363LG0600X	Gerontology Nurse Practitioner
2	207R00000X	Internal Medicine Physician

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	M18786	OTHER	MA	BLUE CROSS GROUP NUMBER

General Provider Information

NPI Number	:	1548212558
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAF MEDICAL ASSOCIATES INC

Provider Business Mailing Address
First Line	:	55 SHARON ANN LN
Second Line	:
City	:	EAST FALMOUTH
State	:	MA
Zip	:	02536-6034
Country	:	US
Telephone Number	:	617-549-5669
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 SHARON ANN LN
Second Line	:
City	:	EAST FALMOUTH
State	:	MA
Zip	:	02536-6034
Country	:	US
Telephone Number	:	617-549-5669
Fax Number	:	617-607-7543

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. ALLA FEYGINA
Credential	:	M.D.
Telephone Number	:	781-438-4625

Provider Enumeration Date	:	05/17/2006
Last Update Date	:	02/25/2022

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