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Individual

DR. COLLEEN A MATTIMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
2924 MAIN ST, BUFFALO, NY 14214-1720
(716) 837-0995
(716) 837-1203
Mailing address
8205 MAIN ST STE 10, WILLIAMSVILLE, NY 14221-6054
(716) 539-0789
(716) 250-9090

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
194429
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00010113101
UNIVERA HEALTHCARE
NY
01
000523597001
BLUE CROSS BLUE SHIELD
NY
05
01559897
NY
01
1207139
INDEPENDENT HEALTH
NY
Enumeration date
01/31/2006
Last updated
02/13/2026
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