Individual
DR. FIDELIS NWAEZEAPU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
3518 ROUTE 281, CORTLAND, NY 13045-3579
(607) 756-2751
Mailing address
3518 ROUTE 281, CORTLAND, NY 13045-3579
(607) 756-2751
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
008247
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SSN
000
NY
Enumeration date
03/24/2019
Last updated
06/11/2019
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