Individual
MATTHEW DEMTRAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
415 HOOPER RD, ENDWELL, NY 13760-3698
(607) 754-3863
Mailing address
415 HOOPER RD, ENDWELL, NY 13760-3698
(607) 754-3863
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
342079
NY
Other
Enumeration date
08/10/2017
Last updated
11/02/2021
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