Organization
PEDIATRIC SERVICE GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS WELCH MD (CHAIRMAN OF DEPARTMENT)
(315) 464-5450
Entity
Organization
Contact information
Practice address
750 E. ADAMS ST., 5TH FLOOR, SYRACUSE, NY 13210
(315) 464-5450
(315) 464-7564
Mailing address
750 E. ADAMS ST., 5TH FLOOR, SYRACUSE, NY 13210
(315) 464-5450
(315) 464-7564
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01215750
—
NY
Enumeration date
05/26/2006
Last updated
10/22/2010
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