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Individual

JASON EDWARD WELLS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
900 ELMGROVE ROAD, ROCHESTER, NY 14624-6236
(585) 426-4100
(585) 453-1462
Mailing address
900 ELMGROVE ROAD, ROCHESTER, NY 14624-6236
(585) 426-4100
(585) 453-1462

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
236925
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02671121
NY
01
7783666
AETNA US HEALTHCARE
01
MDJ047
PREFERRED CARE
NY
01
P010236925
EXCELLUS BLUE CHOICEE
01
P020236925
BLUE SHIELD OF ROCHESTER
NY
Enumeration date
09/14/2006
Last updated
08/03/2012
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