Individual
DR. MATTHEW ALBERT MAVISSAKALIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2540 SHERIDAN DR, TONAWANDA, NY 14150-9410
(716) 874-8980
Mailing address
2157 MAIN ST, BUFFALO, NY 14214-2648
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
293451
NY
Other
Enumeration date
04/02/2013
Last updated
11/05/2018
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