Individual
DR. JAY MITCHELL FEDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3611 SWEETHORN CT, FAIRFAX, VA 22033-1226
(703) 517-2415
Mailing address
3611 SWEETHORN CT, FAIRFAX, VA 22033-1226
(703) 517-2415
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
233752
NY
2085R0202X
Diagnostic Radiology Physician
25MA08982700
NJ
208D00000X
General Practice Physician
Primary
0101044480
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02798507
—
NY
Enumeration date
07/07/2006
Last updated
05/19/2015
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