Individual
CHARLES J FETTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
70 PROFESSIONAL PARKWAY, LOCKPORT, NY 14094-5366
(716) 434-7505
(716) 439-9084
Mailing address
70 PROFESSIONAL PARKWAY, LOCKPORT, NY 14094-5366
(716) 434-7505
(716) 439-9084
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
214954
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02246591
—
NY
Enumeration date
07/04/2006
Last updated
03/28/2023
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