Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | N003302 | NY |
NPI | 1154311439 |
---|---|
Provider Name | Dr. Steven Gene Welsher |
First Address | Long Beach, NY 11561-3302 |
Second Address | Long Beach, NY 11561-3302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 30/06/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00686764 | (05) | NY |
T51047 | (02) | NY |