MR. PETER JOHN FEDORA (NPI# 1659493021) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659493021 |
| Entity Type | Individual |
| Full Name | MR. PETER JOHN FEDORA |
| Credential | L.O. |
| Practice Address |
236 N Main St Manchester CT 06042-2004 |
| Mailing Address |
25 White Rd Tolland CT 06084-2541 |
| Practice Telephone | 8606463577 |
| Practice Fax Number | 8606439733 |
| Mailing Telephone | 8606463577 |
| Mailing Fax Number | 8606439733 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
000601 | CT | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | FEDERAL TAXPAYER ID | 06-1198912 | 01 |
| Street Address |
236 N MAIN ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-2004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750507380 | Fedora Optical Inc | Technician/Technologist | 236 N Main St, Manchester, CT 06042-2004 | 2007-04-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275000960 | Nicole Berger | Behavioral Analyst | 199 Tudor Lane, Apartment E, Manchester, CT 06042 | 2018-10-31 |
| 1902336522 | Karen Scandura | Pharmacist | 260 North Main Street, Manchester, CT 06042 | 2017-06-15 |
| 1053727479 | Sph3enterprise, LLC | Dentist | 194 Buckland Hills Drive, Manchester, CT 06042 | 2014-07-07 |
| 1962657288 | Anthony Michael Gioscia | Optometrist | 344v Buckland Hills Dr, Manchester, CT 06042 | 2008-12-01 |
| 1467635714 | Linda Fernald Gates | Dietitian, Registered | 300 Parker St, Manchester, CT 06042 | 2007-12-10 |
| 1669513909 | Carlos Alfonso Gonzalez | Psychiatry & Neurology | 317 North Main Street, C/o Ccgc, Manchester, CT 06042 | 2007-02-09 |
| 1942350467 | Lise G. O'neill | Counselor | Manchester Memorial Hospital, 71 Haynes St, Manchester, CT 06042 | 2007-01-10 |
| 1558439398 | Jason Allen Sousa | Chiropractor | 1127 Tolland Turnpike, Suite 102, Manchester, CO 06042 | 2006-12-01 |
| 1245332444 | Sharon Soria | Dentist | 192 Main Street, Manchester, TN 06042 | 2006-09-01 |
| 1699732206 | First Choice Health Centers, Inc. | Clinic/Center | 150 N Main St Ste 240, Manchester, CT 06042 | 2006-04-27 |
| Find all providers in zip 06042 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285926220 | Usv Optical Inc. | Technician/Technologist | 1046 Tollard Turnpike, Manchester, CT 06492 | 2011-05-10 |
| 1053447557 | Taylor and Murphy Optical Inc | Technician/Technologist | 545 Hooksett Road Unit 23, Manchester, NH 03104 | 2007-02-26 |
| 1265518534 | Wal-mart Stores East, Lp | Technician/Technologist | 725 Gold Street, Manchester, NH 03103-3218 | 2006-10-30 |
| 1760571558 | Optical Style Bar Inc | Technician/Technologist | 763 Main Street, Manchester, CT 06040-5102 | 2006-10-12 |
| 1316491855 | Laura Crane | Technician/Technologist | 420 Buckland Hills Dr, Manchester, CT 06042-8755 | 2016-08-13 |
| 1477913515 | Matthew Bigos | Technician/Technologist | 420 Buckland Hills Dr, Manchester, CT 06042-8755 | 2016-03-02 |
| 1598125775 | Michael Thompson | Technician/Technologist | 420 Buckland Hills Dr, Manchester, CT 06042-8755 | 2016-03-01 |
| 1053591214 | Richard A Fichman Md PC | Technician/Technologist | 178 Hartford Rd, Manchester, CT 06040-5986 | 2007-11-05 |
| 1750507380 | Fedora Optical Inc | Technician/Technologist | 236 N Main St, Manchester, CT 06042-2004 | 2007-04-18 |
| 1396827200 | Wal-mart Stores East, Lp | Technician/Technologist | 2518 Hillsboro Blvd, Manchester, TN 37355-6535 | 2006-10-19 |
| Find all providers in MANCHESTER | ||||
| City | MANCHESTER |
| Zip Code | 06042 |
Please comment or provide details below to improve the information on MR. PETER JOHN FEDORA.
| 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.