National Provider Identifier
Gregory Manuel Destounis Matos, MD
Gregory Manuel Destounis Matos, MD is listed in the NPPES registry with a primary specialty of Student in an Organized Health Care Education/Training Program in Rochester, NY and a listed phone number of (585) 756-4800.
Profile Overview
- NPI
- 1760123491
- Provider Type
- Individual
- Primary Specialty
- Student in an Organized Health Care Education/Training Program
- Enumeration Date
- April 05, 2022
- Last Updated
- August 01, 2022
Practice Location
- 601 Elmwood Ave
- Rochester, NY 14642-0001
Phone: (585) 756-4800
Mailing Address
- 601 Elmwood Ave
- Rochester, NY 14642-1311
Specialties
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1760123491
- Entity Type
- Individual
- Last Name
- Matos
- First Name
- Gregory
- Middle Name
- Manuel Destounis
- Name Prefix
- Dr.
- Credential
- MD
- Mailing Street Address
- 601 Elmwood Ave
- Mailing City
- Rochester
- Mailing State
- NY
- Mailing ZIP Code
- 14642-1311
- Mailing Country
- US
- Practice Street Address
- 601 Elmwood Ave
- Practice City
- Rochester
- Practice State
- NY
- Practice ZIP Code
- 14642-0001
- Practice Country
- US
- Practice Phone
- (585) 756-4800
- Enumeration Date
- April 05, 2022
- Last Updated
- August 01, 2022
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- August 01, 2022
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Student in an Organized Health Care Education/Training Program (390200000X)