National Provider Identifier
Maria Elena Matala-Sullivan, DO
Maria Elena Matala-Sullivan, DO is listed in the NPPES registry with a primary specialty of Family Medicine Physician in Hamburg, NY and a listed phone number of (716) 646-1084.
Profile Overview
- NPI
- 1912940214
- Provider Type
- Individual
- Primary Specialty
- Family Medicine Physician
- Enumeration Date
- June 14, 2006
- Last Updated
- July 21, 2014
Practice Location
- 4855 Camp RD.
- Suite 100
- Hamburg, NY 14075
Phone: (716) 646-1084
Specialties
- Family Medicine Physician (207Q00000X)
Full Record
- NPI
- 1912940214
- Entity Type
- Individual
- Last Name
- Matala-Sullivan
- First Name
- Maria
- Middle Name
- Elena
- Name Prefix
- Dr.
- Credential
- DO
- Mailing Street Address
- 4855 Camp RD.
- Mailing Address Line 2
- Suite 100
- Mailing City
- Hamburg
- Mailing State
- NY
- Mailing ZIP Code
- 14075
- Mailing Country
- US
- Mailing Phone
- (716) 646-1084
- Mailing Fax
- (716) 646-0786
- Practice Street Address
- 4855 Camp RD.
- Practice Address Line 2
- Suite 100
- Practice City
- Hamburg
- Practice State
- NY
- Practice ZIP Code
- 14075
- Practice Country
- US
- Practice Phone
- (716) 646-1084
- Practice Fax
- (716) 646-0786
- Enumeration Date
- June 14, 2006
- Last Updated
- July 21, 2014
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Family Medicine Physician (207Q00000X)
- Other Identifiers
- 404544 (NY, Wellcare), 01874813 (NY)