1639136682 NPI number — DR. MATTHEW J CYWINSKI MD

Table of content: DR. MATTHEW J CYWINSKI MD (NPI 1639136682)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639136682 NPI number — DR. MATTHEW J CYWINSKI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CYWINSKI
Provider First Name:
MATTHEW
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1639136682
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/06/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
425 ESSJAY RD STE 170
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14221-8235
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-630-1219
Provider Business Mailing Address Fax Number:
716-817-1726

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
295 ESSJAY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-8216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-834-4237
Provider Business Practice Location Address Fax Number:
716-834-3639
Provider Enumeration Date:
04/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 208C00000X , with the licence number:  206063-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 161000580 . This is a "NORTH AMERICAN PREFERED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 161000580 . This is a "EMPIRE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0021748 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000524692002 . This is a "HEALTH NOW" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01843425 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1409274 . This is a "IHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 206063-0B . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 280000943 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 161000580 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com