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Individual

JAY RICHARD SWANSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
APRN-BC

Contact information

Practice address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 595-1100
Mailing address
191 N MAIN ST, WELLSVILLE, NY 14895-1150
(585) 595-1100

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
715559
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F307721
NY

Other

Enumeration date
06/20/2012
Last updated
03/22/2017
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