MEDICARE: EDWIN RONALD FEINTECH PHD PSYCHOLOGY

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	103TC0700X	Clinical Psychologist	PS572	ME

General Provider Information

NPI Number	:	1740269190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWIN RONALD FEINTECH PHD PSYCHOLOGY

Provider Business Mailing Address
First Line	:	15 GRAYSTONE RD
Second Line	:
City	:	GRAY
State	:	ME
Zip	:	04039-7517
Country	:	US
Telephone Number	:	207-415-5290
Fax Number	:

Provider Business Practice Location Address
First Line	:	15 GRAYSTONE RD
Second Line	:
City	:	GRAY
State	:	ME
Zip	:	04039-7517
Country	:	US
Telephone Number	:	207-415-2908
Fax Number	:

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

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	01/07/2021

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