Provider Demographics
NPI:1740256809
Name:WELT, SYDNEY (MD)
Entity type:Individual
Prefix:DR
First Name:SYDNEY
Middle Name:
Last Name:WELT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 SAINT JOSEPHS BLVD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14901-3223
Mailing Address - Country:US
Mailing Address - Phone:607-737-7814
Mailing Address - Fax:607-271-3430
Practice Address - Street 1:555 SAINT JOSEPHS BLVD
Practice Address - Street 2:
Practice Address - City:ELMIRA
Practice Address - State:NY
Practice Address - Zip Code:14901-3223
Practice Address - Country:US
Practice Address - Phone:607-737-7814
Practice Address - Fax:607-271-3430
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2011-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD423962207RX0202X
NY140383-1207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1010267840001Medicaid
NYCC8362OtherRR MEDICARE GROUP
PACC9269OtherRR MEDICARE GROUP
PAP00337163OtherRR MEDICARE PIN
NYP00098799OtherRR MEDICARE PIN
PAGU039841OtherPA MEDICARE GROUP
NY00684840Medicaid
NY00684840Medicaid
NYJ400001851Medicare PIN
PAGU039841OtherPA MEDICARE GROUP
C11612Medicare UPIN