Basic Information
| Provider Information | |||||||||
| NPI: | 1245544634 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEIN | ||||||||
| FirstName: | SHULAMIS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | M.S. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1023 E 12TH ST | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112304126 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7186771834 | ||||||||
| FaxNumber: | 7186771834 | ||||||||
| Practice Location | |||||||||
| Address1: | 1651 CONEY ISLAND AVE | ||||||||
| Address2: | |||||||||
| City: | BROOKLYN | ||||||||
| State: | NY | ||||||||
| PostalCode: | 112305849 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7189981415 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2010 | ||||||||
| LastUpdateDate: | 07/28/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 841113 | NY | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.