Vivian Kudgus Fasula M.D.

NPI 1073570396 - Ophthalmology - 207W00000X

NPI Details
NPI 1073570396
Gender Female
Enumeration Date 04/28/2006
Last Updated 05/14/2009
Entity Type Individual
Active Over 10 years ago
Practice Location
70 PROFESSIONAL PARKWAY
LOCKPORT NY, 14094-5366, US
Phone (716) 434-7505
Fax
Business Location
1254 CHARLESGATE CIRCLE
EAST AMHERST NY, 14051-1216, US
Phone (716) 636-0113
Fax
Toxanomy
Taxonomy Code 207W00000X
License State New York
License Number 148889
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According to our database, Dr. Vivian Kudgus Fasula M.D. NPI is 1073570396, taxonomy code is 207W00000X and license number is 148889, license state is located at New York. Vivian Kudgus Fasula M.D. physically located at 70 Professional Parkway, Lockport NY, 14094-5366. NPI Number Vivian Kudgus Fasula M.D. has the Individual type.

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1073570396 NPI number is provided on an as is basis without warranty of any kind. 1073570396 is maintained by the National Plan & Provider Enumeration System. The contents of Vivian Kudgus Fasula M.D. are for informational purposes only.