National Provider Identifier

Matthew S Ujevich, DO

Matthew S Ujevich, DO is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Ithaca, NY and a listed phone number of (607) 257-5858.

NPI 1124555206Ithaca, NYFamily Medicine Physician

Profile Overview

NPI
1124555206
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
May 19, 2017
Last Updated
September 21, 2023

Practice Location

  • 1780 Hanshaw RD
  • Ithaca, NY 14850-9105

Phone: (607) 257-5858

Mailing Address

  • 120 Chambers Dr
  • Monaca, PA 15061-1349

Specialties

  • Family Medicine Physician (207Q00000X)
  • Family Medicine Physician (207Q00000X)
Full Record
NPI
1124555206
Entity Type
Individual
Last Name
Ujevich
First Name
Matthew
Middle Name
S
Credential
DO
Mailing Street Address
120 Chambers Dr
Mailing City
Monaca
Mailing State
PA
Mailing ZIP Code
15061-1349
Mailing Country
US
Mailing Phone
(724) 630-8384
Practice Street Address
1780 Hanshaw RD
Practice City
Ithaca
Practice State
NY
Practice ZIP Code
14850-9105
Practice Country
US
Practice Phone
(607) 257-5858
Enumeration Date
May 19, 2017
Last Updated
September 21, 2023
Sex
Male
Sole Proprietor
Yes
Taxonomy Group 1
193200000X Multi-Specialty Group
Taxonomy Group 2
193200000X Multi-Specialty Group
Certification Date
September 21, 2023
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X), Family Medicine Physician (207Q00000X)