Individual
MR. MATTHEW K. FAIRBANK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPA-C
Contact information
Practice address
1 ATWELL RD, COOPERSTOWN, NY 13326
(607) 547-3180
Mailing address
1 ATWELL RD, COOPERSTOWN, NY 13326
(607) 547-3480
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007814
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02321204
—
NY
Enumeration date
07/11/2005
Last updated
10/08/2025
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