Individual
DR. MICHAEL JOSEPH FEDAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
655 PARK AVE, NEW YORK, NY 10065-5937
(212) 396-2888
Mailing address
655 PARK AVE, NEW YORK, NY 10065-5937
(212) 396-2888
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
134691
NY
2084P0800X
Psychiatry Physician
Primary
134691
NY
2084P0802X
Addiction Psychiatry Physician
134691
NY
Other
Enumeration date
10/05/2012
Last updated
10/05/2012
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