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Charles W Mistretta, DPM
Foot Surgery Podiatrist in Jamestown, New York
NPI 1083624209

Charles W Mistretta is a Foot Surgery Podiatrist based in Jamestown, NY and is specialized in Foot Surgery. Charles W Mistretta practices in Jamestown, NY and has the professional credentials of DPM. The NPI Number for Charles W Mistretta is 1083624209 and holds a License No. N4011 (New York).

The current practice location address for Charles W Mistretta is 23 Ivy St, Jamestown, NY and can be reached out via phone at 716-664-9698.

Location: 23 Ivy St, Jamestown, NY, 14701-8212
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1083624209
Provider Name
Charles W Mistretta
Credential
DPM
Provider Entity Type
Individual
Gender
Male
Address
23 Ivy St, Jamestown, NY, 14701-8212
Phone Number
716-664-9698
Fax Number
Provider Enumeration Date
08/09/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00957731 05 NY
AA1409 01 NY MEDICARE-PTAN
institution
Provider Business Practice Location Address Details
Address
23 Ivy St
City
Jamestown
State
New York
Zip
14701-8212
Phone Number
716-664-9698
Fax Number
person
Provider Business Mailing Address Details
Address
23 Ivy St
City
Jamestown
State
New York
Zip
14701-8212
Phone Number
716-664-9698
Fax Number
person
Provider's Taxonomy Details 1
Type
Podiatric Medicine & Surgery Service Providers
Classification
Podiatrist
Speciality
Foot Surgery
Taxonomy
213ES0131X
License No.
N4011 (New York)
Definition
Definition to come...
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