DR. MATTHEW JORDAN DICKSON (NPI# 1528021706) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528021706 |
| Entity Type | Individual |
| Full Name | DR. MATTHEW JORDAN DICKSON |
| Credential | M.D. |
| Practice Address |
2 Broad Street Plz Adirondack Ent Glens Falls NY 12801-4363 |
| Mailing Address |
100 Park Street Glens Falls Hospital - Credentialing Glens Falls NY 12801-4413 |
| Practice Telephone | 5189261380 |
| Practice Fax Number | 5189261385 |
| Mailing Telephone | 5189265924 |
| Mailing Fax Number | 5189266983 |
| Enumeration Date | 2006-04-10 |
| Last Update Date | 2019-08-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207YS0123X |
Otolaryngology Specialization: Facial Plastic Surgery |
57061 | GA | Allopathic & Osteopathic Physicians |
| Y | 207YX0905X |
Otolaryngology Specialization: Otolaryngology/Facial Plastic Surgery |
244280 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02897047 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750578118 | Matthew Dickson | Chiropractor | 20269 Smoky Hill Rd, Unit J, Centennial, CO 80015 | 2007-10-01 |
| 1457388720 | Matthew Douglas Dickson | Emergency Medicine | 1628 Palm Ave, San Diego, CA 92154-1027 | 2006-06-26 |
| 1760913131 | Matthew E Dickson | Psychologist | 1662 Village Grn, Crofton, MD 21114-2014 | 2017-03-27 |
| 1659663466 | Matthew C Dickson | Radiology | 2950 S Maryland Pkwy, Las Vegas, NV 89109-2204 | 2011-05-11 |
| 1588806749 | Matthew Dickson | Internal Medicine | 3142 Horizon Rd Ste 110, Rockwall, TX 75032-7810 | 2009-04-01 |
| 1437321502 | Matthew Price Dickson | Psychologist | 1441 E Maple Ave, Burton, MI 48529-2059 | 2008-03-29 |
| 1164621397 | Matthew Robert Dickson | Dentist | 601 E Georgia St, Woodruff, SC 29388-1953 | 2007-07-17 |
| 1629018031 | Matthew Dickson | Emergency Medicine | 500 S Cleveland Ave, Westerville, OH 43081-8971 | 2006-06-07 |
| Street Address |
2 BROAD STREET PLZ ADIRONDACK ENT |
| City | GLENS FALLS |
| State | NY |
| Zip Code | 12801-4363 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144214503 | Thomas Kandora | Internal Medicine | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2005-08-31 |
| 1376891317 | Glens Falls Hospital Inc | Internal Medicine | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4789 | 2012-08-23 |
| 1518215565 | Glens Falls Hospital Inc | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2012-08-23 |
| 1144508144 | Elizabeth Hutchins | Nurse Practitioner | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2011-07-26 |
| 1255636239 | Catherine Reichen | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-21 |
| 1174828636 | Robert J Collette | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-14 |
| 1407151996 | Laura A Rhodes | Physical Therapist | 2 Broad Street Plz, Glens Falls, NY 12801-4363 | 2011-01-14 |
| 1669675203 | Raju Sadal | Physician Assistant | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2007-06-11 |
| 1417001025 | Sean Michael Kennedy | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2007-01-22 |
| 1972680288 | Mark H Weidner | Internal Medicine | 2 Broad Street Plz, Broad Street Medical Group, Glens Falls, NY 12801-4363 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629549399 | Upstate Vision Care, Pllc | Technician/Technologist | 206 Glen St. Suite 31b, Colvin Building, Glens Falls, NY 12801 | 2018-12-06 |
| 1043737356 | Tiffany Britt | Social Worker | 43 Kensington Rd, Glens Falls, NY 12801 | 2017-08-28 |
| 1922375922 | Kathleen A Callaghan | Registered Nurse | 43 Kensington Road, Glens Falls, NY 12801 | 2011-11-19 |
| 1043595531 | Nancy K. Carroll | Social Worker | 37 Broad St., Glens Falls, NY 12801 | 2011-10-15 |
| 1992027528 | Benjamin Alan Rametta | Pharmacist | 202 Broad Street, Walgreens, Glens Falls, NY 12801 | 2010-02-23 |
| 1194052563 | Angela M Lalla | Audiologist | 318 Ridge Street, Glens Sallas, NY 12801 | 2009-11-05 |
| 1407018591 | Marilyn J Bryan | Counselor | 4 Technical Park, Suite #3, #6, Glens Falls, NY 12801 | 2008-06-30 |
| 1104087667 | Chase Chiropractic LLC | Chiropractor | 17 Pine St. 1 Irongate Center, Suite 3, Glens Falls, NY 12801 | 2008-06-18 |
| 1619183571 | Glens Falls Crossings LLC | Skilled Nursing Facility | 170 Warren Street, Glens Falls, NY 12801 | 2007-05-15 |
| 1417099706 | Patricia Ann Cameron | Psychologist | 464 Glen Street, Glens Falls, NY 12801 | 2007-02-13 |
| Find all providers in zip 12801 | ||||
| Taxonomy Code | 207YX0905X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngology/Facial Plastic Surgery |
| An otolaryngologist who specializes in the diagnosis and surgical treatment of head and neck conditions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417001025 | Sean Michael Kennedy | Otolaryngology | 2 Broad Street Plz, Adirondack Ent, Glens Falls, NY 12801-4363 | 2007-01-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093328874 | Conall Fitzgerald | Otolaryngology | 1275 York Ave Dept Head, New York, NY 10065-6007 | 2020-08-31 |
| 1609484492 | Manhattan Facial Plastic Surgery and Ear Nose & Throat Professional Co | Otolaryngology | 400 East 20th Street Ste 3f, New York, NY 10009 | 2020-07-17 |
| 1154838977 | Manhattan Canal Medical, P.C. | Otolaryngology | 202 Canal St Ste 602, New York, NY 10013-4517 | 2018-01-02 |
| 1437538881 | Jacob Ibrook Tower | Otolaryngology | 130 East 77th Street Black Hall Building 10th Floor, New York, NY 10075 | 2015-05-19 |
| 1982808614 | Rebecca E Fraioli | Otolaryngology | 3400 Bainbridge Ave, Map 3, Montefiore Medical Center, Dept of Otolaryngology - Hns, Bronx, NY 10467 | 2007-06-14 |
| 1043429483 | David O Volpi | Otolaryngology | 262 Central Park W # 1h, New York, NY 10024-3512 | 2007-05-22 |
| 1487877817 | Western New York Ear, Nose & Throat, P.C. | Otolaryngology | 3670 South Benzing, Suite C, Orchard Park, NY 14127 | 2007-04-11 |
| 1821157751 | Jennifer M Levine | Otolaryngology | 240 E 79th St, New York, NY 10075-1257 | 2006-12-06 |
| 1104913185 | William Marshall Portnoy | Otolaryngology | 160 W 18th St, Ground Floor, New York, NY 10011-5403 | 2006-10-09 |
| 1609821297 | Boris Chernobilsky | Otolaryngology | 240 E 38th St Fl 14, New York, NY 10016 | 2006-05-23 |
| Find all providers with the same taxonomy | ||||
| City | GLENS FALLS |
| Zip Code | 12801 |
Please comment or provide details below to improve the information on DR. MATTHEW JORDAN DICKSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.