Basic Information
| Provider Information | |||||||||
| NPI: | 1396724530 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEINBERG | ||||||||
| FirstName: | JILL | ||||||||
| MiddleName: | J. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4300 HOUMA BLVD | ||||||||
| Address2: | STE 204 | ||||||||
| City: | METAIRIE | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700062924 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5045037000 | ||||||||
| FaxNumber: | 5045036730 | ||||||||
| Practice Location | |||||||||
| Address1: | 708 W ESPLANADE AVE | ||||||||
| Address2: | |||||||||
| City: | KENNER | ||||||||
| State: | LA | ||||||||
| PostalCode: | 700652736 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9857351198 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/16/2006 | ||||||||
| LastUpdateDate: | 03/13/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 03/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 017924 | LA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | G6438 | 01 | LA | BLUECROSS BLUESHIELD | OTHER | 1365858 | 05 | LA | MEDICAID |