Provider Demographics
NPI:1316272586
Name:FEDER, BARRY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:BARRY
Middle Name:ALAN
Last Name:FEDER
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 1:425 MADEIRA BLVD
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-5295
Mailing Address - Country:US
Mailing Address - Phone:516-205-0824
Mailing Address - Fax:
Practice Address - Street 1:425 MADEIRA BLVD
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-5295
Practice Address - Country:US
Practice Address - Phone:516-205-0824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY239701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice