Healthcare Provider Details
I. General information
NPI: 1710140900
Provider Name (Legal Business Name): MATTHEW JOHN MCKAY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 07/08/2008
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
803 SHERRILL RD
SHERRILL NY
13461-1455
US
IV. Provider business mailing address
150 BROAD ST
HAMILTON NY
13346-9575
US
V. Phone/Fax
- Phone: 315-363-0550
- Fax: 315-370-3696
- Phone: 315-824-6549
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 249242 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: