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General NPI Number Information
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NPI Number | 1134146228
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Entity Type | Individual
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Provider Name | STEPHEN A FELTUS OD
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Gender | Male
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 04/19/2012
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Provider Practice Location Address
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Address Line | 2000 MEMORIAL DR SUITE 6
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-8321
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Country | US
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Telephone | 802-748-3536
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Fax | 802-748-4838
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Provider Business Mailing Address
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Address Line | 2000 MEMORIAL DR SUITE 6
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City | ST JOHNSBURY
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State | VT
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Zip | 05819-8321
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Country | US
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Telephone | 802-748-3536
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Fax | 802-748-4838
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WL0500X
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Taxonomy Name | Low Vision Rehabilitation Optometrist
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License Number | 030-0000162
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License Number State | VT
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