Fedullo, John Lewis

Fedullo, John Lewis is an individual health care provider with primary practice located at 4988 State Highway 30 , Amsterdam NY 12010-7520. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation. Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation is his primary health care specialty. Fedullo, John Lewis can be contacted via phone (518) 841-3481.

Contact Information

Primary practice address
4988 State Highway 30 Amsterdam NY 12010-7520
Phone: (518) 841-3481
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 197917 New York
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 197917 New York

Profile Details

NPI number 1538364237
LBN Legal business name Fedullo, John Lewis
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 20th, 2007
Last updated Dec 20th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538364237 NPPES
New York Other 1720051428 GROUP NPI
New York MEDICAID 01762629 GROUP NPI

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