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NPI Code Detail

MEDICARE: DR. MATTHEW M FERNAAYS MD

MEDICARE: DR. MATTHEW M FERNAAYS 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
1207Q00000XFamily Medicine Physician257231NY

General Provider Information

NPI Number : 1699940940
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MATTHEW M FERNAAYS MD
Provider Business Mailing Address
First Line : 860 MAIN RD
Second Line :
City : CORFU
State : NY
Zip : 14036-9753
Country : US
Telephone Number : 585-599-6446
Fax Number : 585-599-3166
Provider Business Practice Location Address
First Line : 860 MAIN RD
Second Line :
City : CORFU
State : NY
Zip : 14036-9753
Country : US
Telephone Number : 585-599-6446
Fax Number : 585-599-3166
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2008
Last Update Date : 07/26/2011

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