MEDICARE: DR. JENNIFER JO ADAMSON 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	207Q00000X	Family Medicine Physician	229948-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	000527933001	OTHER	NY	COMMUNITY BLUE
3	0112705	OTHER	NY	IHA
4	041116000053	OTHER	NY	FIDELIS
5	00026999601	OTHER	NY	UNIVERA

General Provider Information

NPI Number	:	1851366017
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER JO ADAMSON M.D.

Provider Business Mailing Address
First Line	:	4784 E EDDY DR
Second Line	:
City	:	LEWISTON
State	:	NY
Zip	:	14092-1136
Country	:	US
Telephone Number	:	716-754-4607
Fax Number	:

Provider Business Practice Location Address
First Line	:	3003 9TH ST
Second Line	:
City	:	NIAGARA FALLS
State	:	NY
Zip	:	14305-1931
Country	:	US
Telephone Number	:	716-284-8919
Fax Number	:	716-284-0428

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

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	07/01/2009

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