Provider Demographics
NPI:1386974467
Name:MATSON, BENJAMIN L (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:L
Last Name:MATSON
Suffix:
Gender:
Credentials:MD
Other - Prefix:DR
Other - First Name:BENJAMIN
Other - Middle Name:L
Other - Last Name:MATSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5959 BIG TREE RD
Mailing Address - Street 2:STE 108
Mailing Address - City:ORCHARD PARK
Mailing Address - State:NY
Mailing Address - Zip Code:14127-2291
Mailing Address - Country:US
Mailing Address - Phone:716-810-7997
Mailing Address - Fax:716-242-0249
Practice Address - Street 1:5959 BIG TREE RD
Practice Address - Street 2:SUITE 108
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14127-2291
Practice Address - Country:US
Practice Address - Phone:716-810-7997
Practice Address - Fax:716-242-0249
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282400207L00000X, 207LP2900X, 208VP0000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine