Individual
DR. ANTHONY J FEDULLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1425 PORTLAND AVE, ROCHESTER, NY 14621-3001
(585) 922-4409
(585) 922-4833
Mailing address
1425 PORTLAND AVE, BOX 242, ROCHESTER, NY 14621-3001
(585) 922-4409
(585) 922-4833
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
126101
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00469365
—
NY
Enumeration date
05/24/2006
Last updated
11/11/2013
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