Provider Demographics
NPI:1245457209
Name:FELDBUSCH, SUSAN JANE
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:JANE
Last Name:FELDBUSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 SMITHFIELD STREET
Mailing Address - Street 2:SUITE 1360
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-3937
Mailing Address - Country:US
Mailing Address - Phone:412-281-0503
Mailing Address - Fax:412-281-0203
Practice Address - Street 1:650 SMITHFIELD STREET
Practice Address - Street 2:SUITE 1360
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15222-3937
Practice Address - Country:US
Practice Address - Phone:412-281-0503
Practice Address - Fax:412-281-0203
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NONE156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA53538OtherDAVIS VISION
PAOP2153OtherEYEMED VISION CARE
PAPA00650OtherVISION BENEFITS OF AMERIC