Provider Demographics
NPI:1144307414
Name:FEINBERG, DENNIS L (MD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:L
Last Name:FEINBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2875 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-4979
Mailing Address - Country:US
Mailing Address - Phone:203-375-3411
Mailing Address - Fax:
Practice Address - Street 1:2875 MAIN STREET
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-4979
Practice Address - Country:US
Practice Address - Phone:203-375-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2010-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT22598207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B84138Medicare UPIN
070000115Medicare ID - Type Unspecified