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Individual

JAIME FETES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
3085 HARLEM RD, STE 200, CHEEKTOWAGA, NY 14225-2563
(716) 844-5000
Mailing address
3085 HARLEM RD, SUITE 350, CHEEKTOWAGA, NY 14225-2591
(716) 844-5500
(716) 844-5750

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
012630-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01417481
NY
01
P00638154
RR MEDICARE
NY
Enumeration date
07/22/2008
Last updated
08/13/2015
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