Individual
DR. ERIC FETHKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
212 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4009
(845) 703-7000
(845) 703-0160
Mailing address
212 CRYSTAL RUN RD, MIDDLETOWN, NY 10941-4009
(845) 703-7000
(845) 703-0160
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
195450
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01488665
—
NY
Enumeration date
02/23/2006
Last updated
02/07/2013
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