Provider Demographics
NPI:1619700366
Name:WELSH, CASSIDY HANNAH (PA-S)
Entity type:Individual
Prefix:
First Name:CASSIDY
Middle Name:HANNAH
Last Name:WELSH
Suffix:
Gender:F
Credentials:PA-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2245 FAULKNER RD
Mailing Address - Street 2:
Mailing Address - City:HUBBARDSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13355-1100
Mailing Address - Country:US
Mailing Address - Phone:315-273-9454
Mailing Address - Fax:
Practice Address - Street 1:2245 FAULKNER RD
Practice Address - Street 2:
Practice Address - City:HUBBARDSVILLE
Practice Address - State:NY
Practice Address - Zip Code:13355-1100
Practice Address - Country:US
Practice Address - Phone:315-273-9454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program