Individual
MARIA ORELLANA-MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
301 CONNECTICUT ST, BUFFALO, NY 14201
(716) 862-2572
(716) 862-2573
Mailing address
900 HERTEL AVENUE, BUFFALO, NY 14216
(716) 871-1571
(716) 871-1113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
289763-1
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04802599
—
NY
Enumeration date
04/16/2014
Last updated
05/18/2021
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