Mattimore, Colleen A

Mattimore, Colleen A is an individual health care provider with primary practice located at 5800 Big Tree Rd , Orchard Park NY 14127-4116. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Mattimore, Colleen A can be contacted via phone (716) 662-7337.

Contact Information

Primary practice address
5800 Big Tree Rd Orchard Park NY 14127-4116
Phone: (716) 662-7337
Fax: (716) 662-0641
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 194429 New York

Profile Details

NPI number 1053382549
LBN Legal business name Mattimore, Colleen A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2006
Last updated Jul 13th, 2012 - about 12 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 1053382549 NPPES
New York Other 1207139 INDEPENDENT HEALTH
New York Other 00010113101 INDEPENDENT HEALTH
New York Other 000523597001 INDEPENDENT HEALTH
New York MEDICAID 01559897 INDEPENDENT HEALTH

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