National Provider Identifier
Vivian Kudgus Fasula, M.D.
Vivian Kudgus Fasula, M.D. is listed in the NPPES registry with a primary specialty of Ophthalmology Physician in Lockport, NY and a listed phone number of (716) 434-7505.
Profile Overview
- NPI
- 1073570396
- Provider Type
- Individual
- Primary Specialty
- Ophthalmology Physician
- Enumeration Date
- April 28, 2006
- Last Updated
- May 14, 2009
Practice Location
- 70 Professional Parkway
- Lockport, NY 14094-5366
Phone: (716) 434-7505
Mailing Address
- 1254 Charlesgate Circle
- East Amherst, NY 14051-1216
Specialties
- Ophthalmology Physician (207W00000X)
Full Record
- NPI
- 1073570396
- Entity Type
- Individual
- Last Name
- Fasula
- First Name
- Vivian
- Middle Name
- Kudgus
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 1254 Charlesgate Circle
- Mailing City
- East Amherst
- Mailing State
- NY
- Mailing ZIP Code
- 14051-1216
- Mailing Country
- US
- Mailing Phone
- (716) 636-0113
- Practice Street Address
- 70 Professional Parkway
- Practice City
- Lockport
- Practice State
- NY
- Practice ZIP Code
- 14094-5366
- Practice Country
- US
- Practice Phone
- (716) 434-7505
- Enumeration Date
- April 28, 2006
- Last Updated
- May 14, 2009
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Ophthalmology Physician (207W00000X)
- Other Identifiers
- 00824488 (NY), DISABILITY (NY, D30278), 16-1383123 (Federal Id)