Individual
TODD WILLIAM FEDYSHYN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SERVICE COORDINATOR
Contact information
Practice address
45 BREWSTER ST, JOHNSON CITY, NY 13790-2835
(607) 351-9352
Mailing address
45 BREWSTER ST, JOHNSON CITY, NY 13790-2835
(607) 351-9352
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03169371
—
NY
Enumeration date
11/10/2021
Last updated
11/10/2021
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