Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 120462 | NY |
NPI | 1275577348 |
---|---|
Provider Name | Thomas R Welch |
First Address | Syracuse, NY 13210-1603 |
Second Address | Syracuse, NY 13210-1603 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2006 |
Last Update Date | 14/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00526729 | (05) | NY |
A81445 | (02) | NY |