Individual
ANDREW CHARLES MATTELIANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
235 NORTH ST, BUFFALO, NY 14201-1401
(716) 882-0726
(716) 882-3484
Mailing address
235 NORTH ST, BUFFALO, NY 14201-1401
(716) 882-0726
(716) 882-3484
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1598681
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00020527401
UNIVERA
—
01
—
000504431001
COMMUNITY BLUE
—
01
—
005044311
BLUE CROSS OF WNY
—
01
—
00640512
GHI
—
05
—
00959297
—
NY
01
—
3006860
INDEPENDENT HEALTH
—
Enumeration date
05/15/2006
Last updated
05/10/2010
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