Mistretta, Charles W

Mistretta, Charles W is an sole proprietor health care provider with primary practice located at 23 Ivy St , Jamestown NY 14701-8212. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Foot Surgery, which is considered as his primary health care specialty. Mistretta, Charles W can be contacted via phone (716) 664-9698.

Contact Information

Primary practice address
23 Ivy St Jamestown NY 14701-8212
Phone: (716) 664-9698
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Foot Surgery 213ES0131X N4011 New York

Profile Details

NPI number 1083624209
LBN Legal business name Mistretta, Charles W
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 9th, 2006
Last updated Sep 12th, 2011 - about 14 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 1083624209 NPPES
New York MEDICAID 00957731
New York Other AA1409

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