Fedor, Justin P
Fedor, Justin P is an individual health care provider with primary practice located at 5586 Legionnaire Dr Ste 1 , Cicero NY 13039-3504. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Fedor, Justin P can be contacted via phone (315) 699-2837.Contact Information
Primary practice address
5586 Legionnaire Dr Ste 1
Cicero NY 13039-3504
Phone: (315) 699-2837
Fax: (315) 699-2734
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 265947 | New York |
Profile Details
| NPI number | 1982831483 |
|---|---|
| LBN Legal business name | Fedor, Justin P |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 11th, 2009 |
| Last updated | Sep 19th, 2012 - about 12 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982831483 | NPPES |
| New York | Other | 265947 | LICENSE |
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