Individual
JOSEPHINE WELLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
818 ELLICOTT ST, BUFFALO, NY 14203-1021
(716) 323-2000
(716) 323-0292
Mailing address
1001 MAIN ST FL 5, BUFFALO, NY 14203-1009
(716) 323-0034
(716) 323-0292
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
161363
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010187602
UNIVERA
NY
01
—
000523557005
BLUE CROSS
NY
05
—
00885218
—
NM
01
—
051205000076
FIDELIS
NY
01
—
1208576
INDEPENDENT HEALTH
NY
01
—
145775DL
PREFERRED CARE
NY
Enumeration date
07/06/2006
Last updated
03/08/2023
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