Individual
JEREMY M WELSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA
Contact information
Practice address
5100 W TAFT RD, SUITE 1C, LIVERPOOL, NY 13088-3807
(315) 452-2333
(315) 452-2336
Mailing address
5100 W. TAFT RD, SUITE 1C, LIVERPOOL, NY 13088-4868
(315) 452-2333
(315) 452-2336
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
009596
NY
363AM0700X
Medical Physician Assistant
Primary
009596
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02565557
—
NY
Enumeration date
04/06/2006
Last updated
11/08/2012
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