Individual
DR. CHARLES ANTHONY FONTANA
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
200 MADISON AVE, ELMIRA, NY 14901-3218
(607) 733-5161
Mailing address
8 COBBLES ST E, ELMIRA, NY 14905-2033
(607) 733-5161
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
11172-2
NY
Other
Enumeration date
05/31/2006
Last updated
07/08/2007
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