CHARLES J FETTERMAN MD PC (NPI# 1316004013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316004013 |
| Entity Type | Organization |
| Organization Name | CHARLES J FETTERMAN MD PC |
| Practice Address |
70 Professional Pkwy Lockport NY 14094-5366 |
| Practice Telephone | 7164347505 |
| Practice Fax Number | 7164399084 |
| Mailing Telephone | 7164347505 |
| Mailing Fax Number | 7164399084 |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2010-05-21 |
| Authorized Official Name | MS. CYNTHIA A WEINHEIMER (OFFICE MANAGER) |
| Authorized Official Telephone | 7164347505 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 148889-1 | NY | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 251762-1 | NY | Allopathic & Osteopathic Physicians |
| Y | 207W00000X | Ophthalmology | 214954-1 | NY | Allopathic & Osteopathic Physicians |
| Street Address |
70 PROFESSIONAL PKWY |
| City | LOCKPORT |
| State | NY |
| Zip Code | 14094-5366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700943388 | Vivian K. Fasula, Md PC | Technician/Technologist | 70 Professional Pkwy, Lockport, NY 14094-5366 | 2007-01-02 |
| 1770724635 | Andrea M Buccilli | Ophthalmology | 70 Professional Pkwy, Lockport, NY 14094-5366 | 2009-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093377723 | Sarah A Shaw Od Optometrist Pllc | Optometrist | 215 East Avenue, Lockport, NY 14094 | 2019-07-02 |
| 1780168732 | Woodbridge Nurse Practitioner In Psychiatry Pllc | Clinic/Center | 680 Davison Road, Lockport, NY 14094 | 2018-09-17 |
| 1124512249 | Leleya Tsygyrlash | Registered Nurse | 6332 Green Valley Lane, Lockport, NY 14094 | 2018-06-21 |
| 1699226811 | Jessica Monroe | Specialist | 51 High Street, Lockport, NY 14094 | 2016-10-24 |
| 1689127334 | Allison Cuzzacrea | Physician Assistant | 3644 Day Road, Lockport, NY 14094 | 2016-07-29 |
| 1386027878 | Michael T Trombitas | Chiropractor | 244 Bewley Building, Market Street, Lockport, NY 14094 | 2015-07-02 |
| 1407265226 | Mary Len I | Social Worker | 519 Bewley Building, Lockport, NY 14094 | 2014-08-06 |
| 1871904441 | Edtasha New | Registered Nurse | 120 South New York Street, Lockport, NY 14094 | 2014-05-16 |
| 1326469313 | Eastern Niagara Neurology PC | Psychiatry & Neurology | 170 Professional Parkway, Lockport, NY 14094 | 2013-12-18 |
| 1720348261 | Bianca Angelica Belli | Family Medicine | 5875 S. Transit Road, Lockport, NY 14094 | 2012-05-17 |
| Find all providers in zip 14094 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497770580 | John W Crofts | Ophthalmology | 23 Elizabeth Dr, Lockport, NY 14094-5226 | 2006-07-12 |
| 1073570396 | Vivian Kudgus Fasula | Ophthalmology | 70 Professional Parkway, Lockport, NY 14094-5366 | 2006-04-28 |
| 1770724635 | Andrea M Buccilli | Ophthalmology | 70 Professional Pkwy, Lockport, NY 14094-5366 | 2009-03-23 |
| 1922038785 | Charles J Fetterman | Ophthalmology | 70 Professional Parkway, Lockport, NY 14094-5366 | 2006-07-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821607995 | Reginald Camillo Md Pllc | Ophthalmology | 7708 Broadway, Elmhurst, NY 11373-1927 | 2020-07-24 |
| 1366069510 | Rebecca Stein | Ophthalmology | 711 Stewart Ave Ste 160, Garden City, NY 11530-4700 | 2020-07-02 |
| 1548886260 | Bartow Ophthalmology Pllc | Ophthalmology | 2100 Bartow Ave Ste 208, Bronx, NY 10475-4614 | 2020-06-18 |
| 1407485139 | Amy L Kreisberg | Ophthalmology | 25 Byron Ln, Larchmont, NY 10538-1617 | 2020-04-04 |
| 1922634518 | Vision Vibrant Medicine Pllc | Ophthalmology | 837 59th St, Brooklyn, NY 11220-3611 | 2020-03-16 |
| 1710546270 | Ian Chan Md PC | Ophthalmology | 6410 8th Ave # 2a, Brooklyn, NY 11220-4720 | 2019-06-09 |
| 1598320038 | Mid-hudson Family Ophthalmology, Pllc | Ophthalmology | 75 Crystal Run Rd Ste 104a, Middletown, NY 10941-7003 | 2019-05-09 |
| 1144885070 | Nan Alison Sutter Hayworth | Ophthalmology | 214 Mclain St, Mount Kisco, NY 10549-4931 | 2019-05-06 |
| 1104383660 | Shani Golan | Ophthalmology | 325 E 64th St, New York, NY 10065-6709 | 2019-02-20 |
| 1205391224 | Gautam Kamthan Md PC | Ophthalmology | 250 E 39th St Apt 11g, New York, NY 10016-2178 | 2019-02-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.