Healthcare Provider Details

I. General information

NPI: 1194653584
Provider Name (Legal Business Name): ERIC MATTHEWS CRPA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 GENESEE ST # M
AUBURN NY
13021-3401
US

IV. Provider business mailing address

180 GENESEE ST # M
AUBURN NY
13021-3401
US

V. Phone/Fax

Practice location:
  • Phone: 315-282-5351
  • Fax: 315-475-4601
Mailing address:
  • Phone: 315-282-5351
  • Fax: 315-475-4601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number32336
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: