Fedele, Charles Robert

Fedele, Charles Robert is an individual health care provider with primary practice located at 1229 Pennsylvania Avenue , Sayre PA 18840. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Fedele, Charles Robert can be contacted via phone (570) 888-5858.

Contact Information

Primary practice address
1229 Pennsylvania Avenue Sayre PA 18840
Phone: (570) 888-5858
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 119115-1 New York
Allopathic & Osteopathic Physicians / Dermatology 207N00000X MD037378L Pennsylvania

Profile Details

NPI number 1316912116
LBN Legal business name Fedele, Charles Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Jul 8th, 2007 - about 19 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 1316912116 NPPES
New York MEDICAID 00365155

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