Individual
BOBBY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
818 ELLICOTT ST, BUFFALO, NY 14203-1021
(716) 323-0260
(716) 323-0294
Mailing address
1001 MAIN ST FL 5, BUFFALO, NY 14203-1009
(716) 323-0260
(716) 323-0294
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
003058
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000530534003
BC/BS
—
05
—
03014486
—
NY
01
—
080801000081
FIDELIS
—
01
—
2115250
IHA
—
Enumeration date
06/10/2008
Last updated
06/28/2022
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