Individual
MATTHEW JAMES MAURO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2365 S CLINTON AVE STE 200, ROCHESTER, NY 14618-2663
(585) 758-5700
(585) 758-1299
Mailing address
601 ELMWOOD AVENUE BOX 629, ROCHESTER, NY 14642-0001
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
023778
NY
207Y00000X
Otolaryngology Physician
23778
NY
363A00000X
Physician Assistant
023778
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366097693
—
NY
Enumeration date
08/05/2019
Last updated
06/30/2023
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