National Provider Identifier

Matthew A Bennett, M.D.

Matthew A Bennett, M.D. is listed in the NPPES registry with a primary specialty of Family Medicine Physician in North Tonawanda, NY and a listed phone number of (716) 332-2300.

NPI 1215189378North Tonawanda, NYFamily Medicine Physician

Profile Overview

NPI
1215189378
Provider Type
Individual
Primary Specialty
Family Medicine Physician
Enumeration Date
October 21, 2008
Last Updated
February 01, 2011

Practice Location

  • 624 River RD
  • Suite#1
  • North Tonawanda, NY 14120-6563

Phone: (716) 332-2300

Mailing Address

  • 624 River RD
  • Suite #1
  • North Tonawanda, NY 14120-6563

Specialties

  • Family Medicine Physician (207Q00000X)
Full Record
NPI
1215189378
Entity Type
Individual
Last Name
Bennett
First Name
Matthew
Middle Name
A
Name Prefix
Dr.
Credential
M.D.
Provider Other Last Name
A
Provider Other First Name
M
Provider Other Credential Text
MD
Provider Other Last Name Type Code
2
Mailing Street Address
624 River RD
Mailing Address Line 2
Suite #1
Mailing City
North Tonawanda
Mailing State
NY
Mailing ZIP Code
14120-6563
Mailing Country
US
Mailing Phone
(716) 332-2300
Mailing Fax
(716) 332-2280
Practice Street Address
624 River RD
Practice Address Line 2
Suite#1
Practice City
North Tonawanda
Practice State
NY
Practice ZIP Code
14120-6563
Practice Country
US
Practice Phone
(716) 332-2300
Practice Fax
(716) 332-2280
Enumeration Date
October 21, 2008
Last Updated
February 01, 2011
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Medicine Physician (207Q00000X)
Other Identifiers
250570 (NY, License)