Basic Information
| Provider Information | |||||||||
| NPI: | 1477977825 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEDER | ||||||||
| FirstName: | ANTJE | ||||||||
| MiddleName: | BRITTA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 801 W 181ST ST APT 60 | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100334552 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9175575934 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15 WARREN ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100070029 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2122267666 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/05/2014 | ||||||||
| LastUpdateDate: | 02/28/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 290184 | NY | Y | Allopathic & Osteopathic Physicians | Pediatrics |
No ID Information.