Matthew Antalek, D.O.

Individual provider Active NPI Infectious Disease Physician · Williamsville, NY

NPI 1023066065 · NPPES record last updated Sep 8, 2008

Key facts

NPI
1023066065
Entity type
Individual (NPI type 1)
Primary specialty
Infectious Disease Physician 207RI0200X
License
170215-1 (NY)
Practice address
1829 Maple Rd
Suite 202
Williamsville, NY 14221-2700
Phone
(716) 204-5933
Fax
(716) 204-5934
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20061031000392 NY Practitioner - Infectious Disease 8820033228

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
170215-1NYMDInfectious Disease Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 170215-1 NY Yes

Addresses

Primary practice location

1829 Maple Rd
Suite 202
Williamsville, NY 14221-2700

Mailing address

1829 Maple Rd
Suite 202
Williamsville, NY 14221-2700
Phone (716) 204-5933

Other identifiers

IdentifierTypeStateIssuer
01091923MedicaidNY

Other providers in Williamsville, NY

All providers in Williamsville, NY · Infectious Disease Physician in New York

Sources for this page

Verify at the official NPI Registry.