Provider Demographics
NPI:1861709958
Name:FELSER, CHARLENE (OD)
Entity type:Individual
Prefix:DR
First Name:CHARLENE
Middle Name:
Last Name:FELSER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3205 CLARK BUTLER BLVD STE 30
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32608-2436
Mailing Address - Country:US
Mailing Address - Phone:716-868-0733
Mailing Address - Fax:
Practice Address - Street 1:3205 CLARK BUTLER BLVD STE 30
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32608-2436
Practice Address - Country:US
Practice Address - Phone:716-868-0733
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-10
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV-007590-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400033100Medicare PIN