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NPI Code Detail

MEDICARE: MICHAEL JEROME FEENEY PA

MEDICARE: MICHAEL JEROME FEENEY PA
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
1363A00000XPhysician Assistant004964NY
2363A00000XPhysician Assistant25MP00438800NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1740263284
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL JEROME FEENEY PA
Provider Business Mailing Address
First Line : 3458 NEELY RD
Second Line :
City : JB MDL
State : NJ
Zip : 08641-5312
Country : US
Telephone Number : 609-754-9692
Fax Number : 609-754-9223
Provider Business Practice Location Address
First Line : 3458 NEELY RD
Second Line :
City : JB MDL
State : NJ
Zip : 08641-5312
Country : US
Telephone Number : 609-754-9297
Fax Number : 609-754-9223
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/29/2005
Last Update Date : 04/22/2022

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Directions to “ MICHAEL JEROME FEENEY PA” Practice Location

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