Individual
ANIL K MATHUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5285 MAIN ST, WILLIAMSVILLE, NY 14221-5325
(716) 631-9477
(716) 631-3954
Mailing address
5285 MAIN ST, WILLIAMSVILLE, NY 14221-5325
(716) 631-9477
(716) 631-3954
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
111426
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010112701
UNIVERA
NY
01
—
00505183001
BLUE CROSS BLUE SHIELD
NY
05
—
00647383
—
NY
01
—
0403026
INDEPENDENT HEALTH
NY
Enumeration date
11/20/2006
Last updated
07/09/2007
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