Provider Demographics
NPI:1871595157
Name:FEINGLASS, EDWARD J (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:J
Last Name:FEINGLASS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 KENSINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-3916
Mailing Address - Country:US
Mailing Address - Phone:860-612-0485
Mailing Address - Fax:860-224-0766
Practice Address - Street 1:300 KENSINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-3916
Practice Address - Country:US
Practice Address - Phone:860-612-0485
Practice Address - Fax:860-224-0766
Is Sole Proprietor?:No
Enumeration Date:2005-06-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT017777207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1255448155OtherGHMC NPI ID
CT001177773Medicaid
CT41740OtherAETNA REF ID
CT060047OtherHEALTH NET PROV ID
CT004062394Medicaid
CT010017777CT03OtherBCBS N BCFP PROV ID
CT367845OtherWELLCARE MEDICARE
CTP369968OtherOXFORD PROVIDER ID
CT912442OtherHEALTH NET REF ID
CT01217777OtherCIGNA PROV ID
CT5926402OtherCONNECTICARE PROV ID
CT004062394Medicaid
CT010017777CT03OtherBCBS N BCFP PROV ID
B83885Medicare UPIN