National Provider Identifier
Jesse Fodero, MD
Jesse Fodero, MD is listed in the NPPES registry with a primary specialty of Sports Medicine (Emergency Medicine) Physician in Niagara Falls, NY and a listed phone number of (716) 204-3200.
Profile Overview
- NPI
- 1962935460
- Provider Type
- Individual
- Primary Specialty
- Sports Medicine (Emergency Medicine) Physician
- Enumeration Date
- April 11, 2017
- Last Updated
- August 24, 2021
Practice Location
- 6934 Williams RD Ste 600
- Niagara Falls, NY 14304-3081
Phone: (716) 204-3200
Mailing Address
- 4225 Genesee St Ste 400
- Cheektowaga, NY 14225-1994
Specialties
- Sports Medicine (Emergency Medicine) Physician (207PS0010X)
- Emergency Medicine Physician (207P00000X)
- Orthopaedic Surgery Physician (207X00000X)
Full Record
- NPI
- 1962935460
- Entity Type
- Individual
- Last Name
- Fodero
- First Name
- Jesse
- Name Prefix
- Mr.
- Credential
- MD
- Mailing Street Address
- 4225 Genesee St Ste 400
- Mailing City
- Cheektowaga
- Mailing State
- NY
- Mailing ZIP Code
- 14225-1994
- Mailing Country
- US
- Mailing Phone
- (716) 204-3200
- Practice Street Address
- 6934 Williams RD Ste 600
- Practice City
- Niagara Falls
- Practice State
- NY
- Practice ZIP Code
- 14304-3081
- Practice Country
- US
- Practice Phone
- (716) 204-3200
- Enumeration Date
- April 11, 2017
- Last Updated
- August 24, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- August 24, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Sports Medicine (Emergency Medicine) Physician (207PS0010X), Emergency Medicine Physician (207P00000X), Orthopaedic Surgery Physician (207X00000X)