Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 287698 | NY |
Y | 111NI0900X | Internist | 287698 | NY |
N | 207RA0401X | Internist - Addiction Medicine | 287698 | NY |
NPI | 1619395274 |
---|---|
Provider Name | Dr. Jared P Walsh |
First Address | Rochester, NY 14642-0001 |
Second Address | Rochester, NY 14642 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2014 |
Last Update Date | 05/07/2018 |