National Provider Identifier
Jeremy Martin Riedesel, MD
Jeremy Martin Riedesel, MD is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Mayville, NY and a listed phone number of (716) 753-7107.
Profile Overview
- NPI
- 1851610950
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- May 28, 2010
- Last Updated
- July 16, 2021
Practice Location
- 95 E Chautauqua St
- Mayville, NY 14757-0168
Phone: (716) 753-7107
Mailing Address
- 103 Allen St
- Jamestown, NY 14701-6968
Specialties
- Family Medicine Physician (207Q00000X)
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1851610950
- Entity Type
- Individual
- Last Name
- Riedesel
- First Name
- Jeremy
- Middle Name
- Martin
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 103 Allen St
- Mailing City
- Jamestown
- Mailing State
- NY
- Mailing ZIP Code
- 14701-6968
- Mailing Country
- US
- Mailing Phone
- (716) 338-0022
- Practice Street Address
- 95 E Chautauqua St
- Practice City
- Mayville
- Practice State
- NY
- Practice ZIP Code
- 14757-0168
- Practice Country
- US
- Practice Phone
- (716) 753-7107
- Practice Fax
- (716) 753-5367
- Enumeration Date
- May 28, 2010
- Last Updated
- July 16, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- July 16, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X), Family Medicine Physician (207Q00000X)
- Other Identifiers
- J400023488 (NY, Medicare- Type Unspecified), 03247270 (NY)