Provider Demographics
NPI:1770610404
Name:ROBERT A FEENEY MD PC
Entity type:Organization
Organization Name:ROBERT A FEENEY MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:JANE
Authorized Official - Last Name:RIEGLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-336-6800
Mailing Address - Street 1:103 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:NY
Mailing Address - Zip Code:13440-5123
Mailing Address - Country:US
Mailing Address - Phone:315-336-6800
Mailing Address - Fax:315-338-5408
Practice Address - Street 1:103 W COURT ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:NY
Practice Address - Zip Code:13440-5123
Practice Address - Country:US
Practice Address - Phone:315-336-6800
Practice Address - Fax:315-338-5408
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY129973207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00551286Medicaid
NYB81666Medicare UPIN
NY00551286Medicaid