MEDICARE: DR. JARED P WALSH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208M00000X	Hospitalist Physician	287698	NY
2	207R00000X	Internal Medicine Physician	287698	NY
3	207RA0401X	Addiction Medicine (Internal Medicine) Physician	287698	NY

General Provider Information

NPI Number	:	1619395274
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JARED P WALSH M.D.

Provider Business Mailing Address
First Line	:	601 ELMWOOD AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642-0001
Country	:	US
Telephone Number	:	585-275-7424
Fax Number	:	585-273-1041

Provider Business Practice Location Address
First Line	:	601 ELMWOOD AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14642
Country	:	US
Telephone Number	:	585-275-7424
Fax Number	:	585-273-1041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2014
Last Update Date	:	06/08/2026

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