Individual
LOREN WOLSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
33-57 HARRISON ST, JOHNSON CITY, NY 13790-2107
(607) 763-6285
(607) 763-6701
Mailing address
58 LUSK ST, JOHNSON CITY, NY 13790-2541
(607) 763-6293
(607) 763-6717
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
1149181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01427590
—
NY
Enumeration date
09/29/2005
Last updated
07/12/2010
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