Individual
DR. JAMES RAYMOND HERETH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
818 ELLICOTT ST, BUFFALO, NY 14203-1021
(716) 323-0200
(716) 323-0293
Mailing address
1001 MAIN ST FL 4, BUFFALO, NY 14203-1009
(716) 323-0200
(716) 323-0293
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
247895
NY
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
247895
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03103335
—
NY
Enumeration date
07/13/2008
Last updated
01/18/2021
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