MEDICARE: DR. MILLIE R FELL 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	174400000X	Specialist	160237-1	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	180024771	OTHER	NY	RAILROAD MEDICARE

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	:	1780607192
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MILLIE R FELL MD

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	:	718-627-7219

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	:	718-627-7219

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

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	03/27/2012

Similar Medicare Providers

1700091055 — MILLIE R FELL MD PC
Practice Location Address:

2025 KINGS HWY
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11229-1463

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1992006464 — MR. JONATHAN R. FELL LCSW
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1134280050 — MS. JACQUELINE S YATES L.M.S.W., C.A.S.A.C.
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1801922497 — MR. GEORGE SCOTT MATOUS LCSW
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1699801282 — MS. MARGARET L DE HAAN
Practice Location Address:

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Directions to “ DR. MILLIE R FELL MD” Practice Location

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