Provider Demographics
NPI:1538153838
Name:CURTIS, MATTHEW S (OD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:S
Last Name:CURTIS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5532 STATE HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820-3661
Mailing Address - Country:US
Mailing Address - Phone:607-432-2600
Mailing Address - Fax:
Practice Address - Street 1:5532 STATE HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820-3661
Practice Address - Country:US
Practice Address - Phone:607-432-2600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-01
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUVOO5785-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01734041Medicaid
NYRA9545Medicare ID - Type Unspecified
NY01734041Medicaid