National Provider Identifier
Charles W Mistretta, DPM
Charles W Mistretta, DPM is listed in the NPPES registry with a primary specialty of Foot Surgery Podiatrist in Jamestown, NY and a listed phone number of (716) 664-9698.
Profile Overview
- NPI
- 1083624209
- Provider Type
- Individual
- Primary Specialty
- Foot Surgery Podiatrist
- Enumeration Date
- August 09, 2006
- Last Updated
- September 12, 2011
Practice Location
- 23 Ivy St
- Jamestown, NY 14701-8212
Phone: (716) 664-9698
Specialties
- Foot Surgery Podiatrist (213ES0131X)
Full Record
- NPI
- 1083624209
- Entity Type
- Individual
- Last Name
- Mistretta
- First Name
- Charles
- Middle Name
- W
- Credential
- DPM
- Mailing Street Address
- 23 Ivy St
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-8212
- Mailing Country
- US
- Mailing Phone
- (716) 664-9698
- Mailing Fax
- (716) 661-3851
- Practice Street Address
- 23 Ivy St
- Practice City
- Jamestown
- Practice State
- NY
- Practice ZIP Code
- 14701-8212
- Practice Country
- US
- Practice Phone
- (716) 664-9698
- Enumeration Date
- August 09, 2006
- Last Updated
- September 12, 2011
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Foot Surgery Podiatrist (213ES0131X)
- Other Identifiers
- 00957731 (NY), AA1409 (NY, Medicare-Ptan)