Fertakos, Roy J
Fertakos, Roy J is an sole proprietor health care provider with primary practice located at 801 Ostrum St , Bethlehem PA 18015-1000. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Fertakos, Roy J can be contacted via phone (484) 526-4000.Contact Information
Primary practice address
801 Ostrum St
Bethlehem PA 18015-1000
Phone: (484) 526-4000
Fax: (706) 653-1230
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 25MA05686200 | New Jersey |
| Other Service Providers / Specialist | 174400000X | 25MA05686200 | New Jersey |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 062399L | Pennsylvania |
Profile Details
| NPI number | 1356448773 |
|---|---|
| LBN Legal business name | Fertakos, Roy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Sep 3rd, 2020 - about 4 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 | 1356448773 | NPPES |
| New Jersey | Other | 300110976 | RAILROAD MEDICARE - SMC |
| New Jersey | MEDICAID | 001668701 | RAILROAD MEDICARE - SMC |
| New Jersey | Other | 300110976 | RAILROAD MEDICARE - SMC |
| New Jersey | Other | 300110976 | RAILROAD MEDICARE - SMC |
| New Jersey | MEDICAID | 8224005 | RAILROAD MEDICARE - SMC |
| New Jersey | Other | 300110976 | RAILROAD MEDICARE - SMC |
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