Individual
MR. JESSE FODERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6934 WILLIAMS RD STE 600, NIAGARA FALLS, NY 14304-3081
(716) 204-3200
Mailing address
4225 GENESEE ST STE 400, CHEEKTOWAGA, NY 14225-1994
(716) 204-3200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
304141
NY
207PS0010X
Sports Medicine (Emergency Medicine) Physician
Primary
304141
NY
207X00000X
Orthopaedic Surgery Physician
304141
NY
Other
Enumeration date
04/11/2017
Last updated
08/24/2021
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