MEDICARE: MILLIE R FELL MD PC

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	332H00000X	Eyewear Supplier

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	:	1750697074
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MILLIE R FELL MD PC

Provider Business Mailing Address
First Line	:	2025 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1463
Country	:	US
Telephone Number	:	718-339-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	2025 KINGS HWY
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1463
Country	:	US
Telephone Number	:	718-339-6868
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. MILLIE R. FELL
Credential	:	MD
Telephone Number	:	718-339-6868

Provider Enumeration Date	:	08/24/2010
Last Update Date	:	12/27/2011

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Directions to “MILLIE R FELL MD PC ” Practice Location

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