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Individual

DR. JONATHAN NORWOOD COOLIDGE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D

Contact information

Practice address
100 HIGH ST, BUFFALO, NY 14203-1126
(716) 859-1499
(716) 859-1555
Mailing address
30 MAYVILLE AVE, BUFFALO, NY 14217-1821
(518) 669-8327

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
261155
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03371280
NY
Enumeration date
08/15/2010
Last updated
09/11/2019
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