Healthcare Provider Details

I. General information

NPI: 1063099364
Provider Name (Legal Business Name): MATTHEW DEAN COLLIN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2021
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 MAIN ST
BUFFALO NY
14203-1009
US

IV. Provider business mailing address

1001 MAIN ST
BUFFALO NY
14203-1009
US

V. Phone/Fax

Practice location:
  • Phone: 716-829-5050
  • Fax:
Mailing address:
  • Phone: 716-829-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number343711
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: