Individual
DR. JERALD ROBERT SULTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 N FOREST RD, SUITE 1, WILLIAMSVILLE, NY 14221-3277
(716) 634-1970
(716) 634-3845
Mailing address
1301 N FOREST RD, SUITE 1, WILLIAMSVILLE, NY 14221-3277
(716) 634-1970
(716) 634-3845
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
181975
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010309402
UNIVERA
NY
01
—
000524867
BLUE CROSS BLUE SHIELD
NY
01
—
000524867002
COMMUNITY BLUE
NY
01
—
1309949
INDEPEDENT HEALTH
NY
01
—
1320353
UNITED EMPIRE
NY
01
—
16-1605603
TAX IDENTIFER
NY
01
—
50599
CHOICE CARE
NY
01
—
CPS181975-4B
WORKER'S COMPENSATION
NY
Enumeration date
11/30/2006
Last updated
06/05/2008
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