Provider Demographics
NPI:1699712380
Name:FEEN, DENNIS J (MD)
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:J
Last Name:FEEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 821
Mailing Address - Street 2:111 WALPOLE STREET
Mailing Address - City:DOVER
Mailing Address - State:MA
Mailing Address - Zip Code:02030-0821
Mailing Address - Country:US
Mailing Address - Phone:617-243-6128
Mailing Address - Fax:
Practice Address - Street 1:2014 WASHINGTON STREET
Practice Address - Street 2:NEWTON-WELLESLEY HOSP
Practice Address - City:NEWTONVILLE
Practice Address - State:MA
Practice Address - Zip Code:02162
Practice Address - Country:US
Practice Address - Phone:617-243-6128
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA31159207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAB01012Medicare PIN