Individual
JOHN WESTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
200 MADISON AVE FL 3, ELMIRA, NY 14901-3219
(607) 734-1581
(607) 734-0972
Mailing address
571 SAINT JOSEPHS BLVD FL 2, ELMIRA, NY 14901-3230
(607) 271-2050
(607) 873-1244
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
224502-1
NY
207Q00000X
Family Medicine Physician
Primary
224502
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000153632
BLUE SHIELD
NY
05
—
02383448
—
NY
Enumeration date
05/26/2006
Last updated
12/01/2020
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