# CHARLES J FETTERMAN MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316004013
- **Authorized official:** MS. CYNTHIA A WEINHEIMER (OFFICE MANAGER)
- **Authorized official phone:** (716) 434-7505

## Contact information

- **Practice address:** 70 PROFESSIONAL PKWY, LOCKPORT, NY 14094-5366
- **Practice address phone:** (716) 434-7505
- **Practice address fax:** (716) 439-9084
- **Mailing address:** 70 PROFESSIONAL PKWY, LOCKPORT, NY 14094-5366
- **Mailing address phone:** (716) 434-7505
- **Mailing address fax:** (716) 439-9084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 148889-1 | NY | — |
| 207W00000X | Ophthalmology Physician | 214954-1 | NY | Yes |
| 207W00000X | Ophthalmology Physician | 251762-1 | NY | — |

## Other

- **Enumeration date:** 01/02/2007
- **Last updated:** 05/21/2010