Provider Demographics
NPI:1235139684
Name:WELTER, JOHN J (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:J
Last Name:WELTER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:19 BRADHURST AVE
Mailing Address - Street 2:STE 1400
Mailing Address - City:HAWTHORNE
Mailing Address - State:NY
Mailing Address - Zip Code:10532-2140
Mailing Address - Country:US
Mailing Address - Phone:914-493-7585
Mailing Address - Fax:914-594-4336
Practice Address - Street 1:19 BRADHURST AVE
Practice Address - Street 2:STE. 1400
Practice Address - City:HAWTHORNE
Practice Address - State:NY
Practice Address - Zip Code:10532-2140
Practice Address - Country:US
Practice Address - Phone:914-493-7585
Practice Address - Fax:914-594-4336
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2015-01-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY2253382080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02679349Medicaid
NYI33705Medicare UPIN
NY8V079EA202Medicare PIN
NY02679349Medicaid
NY8V079EA201Medicare PIN