Provider Demographics
NPI:1861555708
Name:FEAZELL, JANE M (PSYCHOANALYST)
Entity type:Individual
Prefix:MRS
First Name:JANE
Middle Name:M
Last Name:FEAZELL
Suffix:
Gender:F
Credentials:PSYCHOANALYST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 4TH AVE
Mailing Address - Street 2:SUITE 3C
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11209
Mailing Address - Country:US
Mailing Address - Phone:718-836-1730
Mailing Address - Fax:
Practice Address - Street 1:7201 4TH AVE
Practice Address - Street 2:SUITE 3C
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11209
Practice Address - Country:US
Practice Address - Phone:718-836-1730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000443103TP0814X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TP0814XBehavioral Health & Social Service ProvidersPsychologistPsychoanalysis