MEDICARE: MATTHEW ANTHONY MAURER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0003X	Hematology & Oncology Physician	225147	NY

General Provider Information

NPI Number	:	1144399171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW ANTHONY MAURER MD

Provider Business Mailing Address
First Line	:	1130 SAINT NICHOLAS AVE
Second Line	:	ROOM 217C
City	:	NEW YORK
State	:	NY
Zip	:	10032-3802
Country	:	US
Telephone Number	:	212-851-4761
Fax Number	:	212-851-4572

Provider Business Practice Location Address
First Line	:	1130 SAINT NICHOLAS AVE
Second Line	:	ROOM 217C
City	:	NEW YORK
State	:	NY
Zip	:	10032-3802
Country	:	US
Telephone Number	:	212-851-4761
Fax Number	:	212-851-4572

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	11/23/2008

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