Individual
THERESE FEDEROWICZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
30 HARRISON ST STE 455, JOHNSON CITY, NY 13790-2176
(607) 763-8100
Mailing address
33 LEWIS RD, BINGHAMTON, NY 13905-1048
(607) 729-8156
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
305233
NY
Other
Enumeration date
04/07/2015
Last updated
07/16/2020
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