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MR. MATTHEW JAMES WITTCOP

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
ANP

Contact information

Practice address
1540 MAPLE RD, WILLIAMSVILLE, NY 14221-3647
(716) 568-3600
Mailing address
6292 BADGER DR, LOCKPORT, NY 14094-5919
(716) 478-6739

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306498-1
NY

Other

Enumeration date
07/24/2013
Last updated
07/24/2013
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