# JILL M FETELL

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

## Provider details

- **NPI number:** 1518231463
- **Authorized official:** JILL M FETELL MD (OWNER)
- **Authorized official phone:** (845) 362-8400

## Contact information

- **Practice address:** 26 FIREMENS MEMORIAL DR, SUITE 115, POMONA, NY 10970-3553
- **Practice address phone:** (845) 362-8400
- **Practice address fax:** (845) 362-8474
- **Mailing address:** 13-15 NEPERAN RD, TARRYTOWN, NY 10591-3446
- **Mailing address phone:** (914) 631-7911

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A145931-1 | NY | Yes |

## Other

- **Enumeration date:** 02/23/2012
- **Last updated:** 02/23/2012