DR. MARK ANTHONY MATESICH (NPI# 1568952885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568952885 |
| Entity Type | Individual |
| Full Name | DR. MARK ANTHONY MATESICH |
| Credential | DC |
| Practice Address |
496 Pearl St Buffalo NY 14202-1904 |
| Mailing Address |
29 Knox Ave Lowr Buffalo NY 14216-3310 |
| Practice Telephone | 7167594747 |
| Mailing Telephone | 7167594747 |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-05-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 011157 | NY | Chiropractic Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1002 Elmwood Ave, Buffalo, NY 142221202 | 7167594747 |
| Street Address |
496 PEARL ST |
| City | BUFFALO |
| State | NY |
| Zip Code | 14202-1904 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376141655 | Deborah Elaine Ricci | Counselor | 43o Niagara Sq, Buffalo, NY 14202 | 2020-10-09 |
| 1831716208 | Meagan Licata | Counselor | Bestself Behavioral Health, 255 Delaware Ave Ste 300, Buffalo, NY 14202 | 2020-07-01 |
| 1962022483 | Autumn Marie Hayes I | Counselor | 625 Deleware Avenue, Suite 204, Buffalo, NY 14202 | 2020-04-24 |
| 1861012742 | Natasha Qutab | Student in an Organized Health Care Education/Training Program | Department of Neurology, 1010 Main Street, 2nd Floor, Buffalo, NY 14202 | 2020-04-21 |
| 1396232245 | Wood Dental LLC | Dentist | 564 Franklin Street, Buffalo, NY 14202 | 2018-04-17 |
| 1083130728 | Lydia Heeeun Doublestein | Advanced Practice Midwife | 367 Delaware Ave, Buffalo, NY 14202 | 2017-08-15 |
| 1356861652 | Michelle Cheesman | Speech-Language Pathologist | 801 City Hall, Buffalo, NY 14202 | 2017-06-27 |
| 1275082075 | Tempresst Nycole Batts Ravenell | Registered Nurse | 69 Delaware Ave Suite 1200, Interim Healthcare, Buffalo, NY 14202 | 2016-09-22 |
| 1972974764 | Tiffany Tyran | Registered Nurse | 69 Delaware Ave, Suite 1200, Buffalo, NY 14202 | 2015-10-19 |
| 1487044368 | Katherine Jeffries-coppola | Registered Nurse | 69 Delaware Ave. Suite 1200, Buffalo, NY 14202 | 2015-01-29 |
| Find all providers in zip 14202 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265071997 | Ralph Cafiero | Chiropractor | 1275 Main St # 110, Buffalo, NY 14209-1911 | 2019-12-28 |
| 1669018065 | Elizabeth Marie Moden | Chiropractor | 3685 Harlem Rd Ste 3, Buffalo, NY 14215-2046 | 2019-11-20 |
| 1457820110 | Nicholas R Jones | Chiropractor | 149 Virgil Ave Uppr, Buffalo, NY 14216-1805 | 2018-11-24 |
| 1134698350 | Kyle Fancher | Chiropractor | 1829 Maple Rd Ste 110, Buffalo, NY 14221-2700 | 2018-11-16 |
| 1326514712 | Sarah Soper | Chiropractor | 412 Schiller St, Buffalo, NY 14212-2139 | 2018-10-23 |
| 1710465943 | Andrew Zimmer | Chiropractor | 135 Delaware Ave Frnt 103, Buffalo, NY 14202-2410 | 2018-07-31 |
| 1497244461 | Rafael Ernesto Roman Perez | Chiropractor | 564 Niagara St Bldg 2, Buffalo, NY 14201-1108 | 2018-05-06 |
| 1790223832 | Joshua Nelson | Chiropractor | 1201 Colvin Blvd # A, Buffalo, NY 14223-1936 | 2017-02-09 |
| 1972964674 | Brenda Covell | Chiropractor | 500 Seneca St, Suite 130, Buffalo, NY 14204-1963 | 2016-03-09 |
| 1487014502 | Lindsay Marie Engl | Chiropractor | 2526 Delaware Ave, Suite 102, Buffalo, NY 14216-1702 | 2016-03-02 |
| Find all providers in BUFFALO | ||||
Please comment or provide details below to improve the information on DR. MARK ANTHONY MATESICH.
| 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.