Individual
DR. MATTHEW A BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
624 RIVER RD, SUITE#1, NORTH TONAWANDA, NY 14120-6563
(716) 332-2300
(716) 332-2280
Mailing address
624 RIVER RD, SUITE #1, NORTH TONAWANDA, NY 14120-6563
(716) 332-2300
(716) 332-2280
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
250570
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
250570
LICENSE
NY
Enumeration date
10/21/2008
Last updated
02/01/2011
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