Provider Demographics
NPI:1063949584
Name:FEIGENBAUM, YITZCHAK BARUCH (DDS)
Entity type:Individual
Prefix:DR
First Name:YITZCHAK
Middle Name:BARUCH
Last Name:FEIGENBAUM
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 ROCKWOOD PL
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-4939
Mailing Address - Country:US
Mailing Address - Phone:832-470-3079
Mailing Address - Fax:
Practice Address - Street 1:359 STATE RT 23
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-3141
Practice Address - Country:US
Practice Address - Phone:973-875-3430
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-15
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY600471223G0001X
NJ22DI027326001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice