National Provider Identifier
James Raymond Hereth, M.D.
James Raymond Hereth, M.D. is listed in the NPPES registry with a primary specialty of Pediatric Critical Care Medicine Physician in Buffalo, NY and a listed phone number of (716) 323-0200.
Profile Overview
- NPI
- 1912161530
- Provider Type
- Individual
- Primary Specialty
- Pediatric Critical Care Medicine Physician
- Enumeration Date
- July 13, 2008
- Last Updated
- January 18, 2021
Practice Location
- 818 Ellicott St
- Buffalo, NY 14203-1021
Phone: (716) 323-0200
Mailing Address
- 1001 Main St Fl 4
- Buffalo, NY 14203-1009
Specialties
- Pediatric Critical Care Medicine Physician (2080P0203X)
- Internal Medicine Physician (207R00000X)
Full Record
- NPI
- 1912161530
- Entity Type
- Individual
- Last Name
- Hereth
- First Name
- James
- Middle Name
- Raymond
- Name Prefix
- Dr.
- Credential
- M.D.
- Mailing Street Address
- 1001 Main St Fl 4
- Mailing City
- Buffalo
- Mailing State
- NY
- Mailing ZIP Code
- 14203-1009
- Mailing Country
- US
- Mailing Phone
- (716) 323-0200
- Mailing Fax
- (716) 323-0293
- Practice Street Address
- 818 Ellicott St
- Practice City
- Buffalo
- Practice State
- NY
- Practice ZIP Code
- 14203-1021
- Practice Country
- US
- Practice Phone
- (716) 323-0200
- Practice Fax
- (716) 323-0293
- Enumeration Date
- July 13, 2008
- Last Updated
- January 18, 2021
- Sex
- Male
- Sole Proprietor
- No
- Certification Date
- January 18, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Pediatric Critical Care Medicine Physician (2080P0203X), Internal Medicine Physician (207R00000X)
- Other Identifiers
- 03103335 (NY)