Individual
DR. MARC JEFFREY FEDERBUSCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
6534 MYRTLE AVE, GLENDALE, NY 11385-6212
(718) 366-3338
(718) 366-2633
Mailing address
13 SHELLY CT, PLAINVIEW, NY 11803-5309
(516) 822-3649
(516) 681-3411
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N003554
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00832242
—
NY
01
—
P3601699
OXFORD
NY
Enumeration date
02/07/2006
Last updated
10/27/2007
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