Individual
JORDAN PERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
987 R C HOAG DR, SALAMANCA, NY 14779-1365
(716) 945-5894
Mailing address
987 R C HOAG DR, SALAMANCA, NY 14779-1365
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
263118
NY
207Q00000X
Family Medicine Physician
63012
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463483745
—
NY
Enumeration date
02/02/2010
Last updated
06/12/2024
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