Matala-Sullivan, Maria Elena

Matala-Sullivan, Maria Elena is an individual health care provider with primary practice located at 4855 Camp Rd. Suite 100, Hamburg NY 14075. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Matala-Sullivan, Maria Elena can be contacted via phone (716) 646-1084.

Contact Information

Primary practice address
4855 Camp Rd. Suite 100 Hamburg NY 14075
Phone: (716) 646-1084
Fax: (716) 646-0786
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 210175 New York

Profile Details

NPI number 1912940214
LBN Legal business name Matala-Sullivan, Maria Elena
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 14th, 2006
Last updated Jul 21st, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912940214 NPPES
New York Other 404544 WELLCARE
New York MEDICAID 01874813 WELLCARE

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