Craig M. Fetterman, D.O.,P.C.

Primary specialty

Hospitalist PhysicianTaxonomy code 208M00000X

License

230757-1 Issued in NY

Legal business name

CRAIG M. FETTERMAN, D.O.,P.C.

Practice address

2950 Elmwood Ave
Kenmore, NY 14217-1304

Phone

(716) 634-8800

Fax

(716) 634-8987

NPI assigned

Feb 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Craig M Fetterman, D.O.

Title

President

Phone

(716) 634-8800

Specialties & licenses 1

Addresses

Other identifiers 4

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190160000000",
    "number": "1285779751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 INTERNATIONAL DR",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218217",
            "telephone_number": "716-634-8800",
            "fax_number": "716-634-8987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2950 ELMWOOD AVE",
            "city": "KENMORE",
            "state": "NY",
            "postal_code": "142171304",
            "telephone_number": "716-634-8800",
            "fax_number": "716-634-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CRAIG M. FETTERMAN, D.O.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-09-19",
        "status": "A",
        "authorized_official_last_name": "FETTERMAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "716-634-8800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Hospitalist",
            "state": "NY",
            "license": "230757-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02533062",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNIVERA",
            "identifier": "00026827302",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDEPENDENT HEALTH",
            "identifier": "0412489",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIDELIS",
            "identifier": "061106000022",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Donald Coster, D.C.
• Kathryn A Coughlin
• Kelly N. Courtade
• Emily Jayne Coutts
• Dana Cowley
• Teresa A Crawford, M.S., NYSMHC
• Catherine Cronin-Buettner, CCC-SLP
• Virginia Czaplewski
• Rachael Czarnecki, COTA/L
• Lisa Renee Czosek, MS OTR/L

• Hospitalist Physician in Kenmore, NY
• Providers in Kenmore, NY by specialty
• Hospitalist Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.