Basic Information
| Provider Information | |||||||||
| NPI: | 1114986460 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FEINLAND | ||||||||
| FirstName: | JERALD | ||||||||
| MiddleName: | B. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 5700 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049155700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8664314077 | ||||||||
| FaxNumber: | 4137747448 | ||||||||
| Practice Location | |||||||||
| Address1: | 238 NORTHAMPTON ST | ||||||||
| Address2: | |||||||||
| City: | EASTHAMPTON | ||||||||
| State: | MA | ||||||||
| PostalCode: | 010271046 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4135299300 | ||||||||
| FaxNumber: | 4135277517 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2006 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 156357 | MA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 10255201 | 01 | MA | CIGNA | OTHER | 3180999 | 05 | MA | MEDICAID | 1293385 | 01 | MA | FALLON | OTHER | 2358603 | 01 | MA | AETNA | OTHER | 24458 | 01 | MA | HNE | OTHER | 000000036566 | 01 | MA | BMC | OTHER | 156357 | 01 | MA | CONNECTICARE | OTHER | 156357 | 01 | MA | TUFTS | OTHER | AA78003 | 01 | MA | HPHC | OTHER | J18890 | 01 | MA | BCBSMA | OTHER |