Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. MATTHEW ALBERT MAVISSAKALIAN, D.O.
Active Sole ProprietorDR. MATTHEW ALBERT MAVISSAKALIAN, D.O. is a Allergy & Immunology healthcare provider located in TONAWANDA, New York. NPI 1790028397 is currently active in the NPPES registry. Verify at CMS.
Allergy & Immunology · TONAWANDA, NY
Registration Details
- NPI Number
- 1790028397
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Apr 2, 2013 (13.412913090288 yrs)
- Last Updated
- Nov 5, 2018
- License
-
293451 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
2540 SHERIDAN DRTONAWANDA, NY, 141509410Browse NY providers · Browse ZIP 14150
- Phone
- 7168748980
- Primary Specialty
-
Allergy & Immunology
207K00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.