Provider Demographics
NPI:1306119938
Name:DR. MORRIS J. FEDER
Entity type:Organization
Organization Name:DR. MORRIS J. FEDER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MORRIS
Authorized Official - Middle Name:J
Authorized Official - Last Name:FEDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:718-851-0277
Mailing Address - Street 1:1422 52ND ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11219-3919
Mailing Address - Country:US
Mailing Address - Phone:718-851-0277
Mailing Address - Fax:
Practice Address - Street 1:1422 52ND ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-3919
Practice Address - Country:US
Practice Address - Phone:718-851-0277
Practice Address - Fax:718-851-1312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026920261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental