Diane Lynn Fargo

Primary specialty

OpticianTaxonomy code 156FX1800X

License

009393 Issued in NY

Practice address

2441 Vestal Pkwy E
Vestal, NY 13850-2001

Phone

(607) 770-6297

Fax

(607) 766-9582

NPI assigned

Mar 18, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Mrs. Diane Lynn Masters Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552867200000",
    "number": "1477012631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2441 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502001",
            "telephone_number": "607-770-6297",
            "fax_number": "607-766-9582"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2441 VESTAL PKWY E",
            "city": "VESTAL",
            "state": "NY",
            "postal_code": "138502001",
            "telephone_number": "607-770-6297",
            "fax_number": "607-766-9582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARGO",
        "first_name": "DIANE",
        "middle_name": "LYNN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "NY",
            "license": "009393",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANE",
            "last_name": "MASTERS",
            "middle_name": "LYNN",
            "prefix": "MRS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kazvin Vispy Engineer, OD
• Cassie Erdmann, PA
• Kathryn Ellen Ericksen, GNP
• Sheri Elizabeth Esteban-Elie, PH.D.
• Suzanne Michelle Evans, RN BSN
• Jeff Farinella, P.T.
• Juliana Farrell, PA
• Michael J Farrell, MD
• Sasha Dora Fassett, LCSW
• Therese Federowicz, M.D.

• Optician in Vestal, NY
• Providers in Vestal, NY by specialty
• Optician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.