Provider Demographics
NPI:1588868780
Name:FEULNER, MICHAEL THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:THOMAS
Last Name:FEULNER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 MADISON AVE
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-2511
Mailing Address - Country:US
Mailing Address - Phone:212-605-0144
Mailing Address - Fax:866-496-9601
Practice Address - Street 1:575 MADISON AVE
Practice Address - Street 2:10TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-2511
Practice Address - Country:US
Practice Address - Phone:212-605-0144
Practice Address - Fax:866-496-9601
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2011-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX010948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY20-1825336OtherTAX ID
NY20-1825336OtherTAX ID
NYX7R951Medicare ID - Type UnspecifiedPROVIDER