DR. Vivian Kudgus Fasula, M.D.

NPI #1073570396 in Lockport, New York

Provider Information

NPI Number: 1073570396
Entity Type: Individual
Name: DR. Vivian Kudgus Fasula, M.D.
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Ophthalmology
Credential: M.D.
Enumeration Date: Apr 28, 2006
Last Updated: May 14, 2009

Practice Location

Address: 70 PROFESSIONAL PARKWAY
City: Lockport
State: New York
ZIP Code: 14094-5366
Phone: (716) 434-7505

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Ophthalmology	207W00000X	Primary

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