Provider Demographics
NPI:1548495468
Name:RYZEWSKI, MATTHEW WILLIAM (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:WILLIAM
Last Name:RYZEWSKI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1 ELLIOT WAY
Mailing Address - Street 2:NICU
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03103-3502
Mailing Address - Country:US
Mailing Address - Phone:603-663-2692
Mailing Address - Fax:603-663-3982
Practice Address - Street 1:1 ELLIOT WAY
Practice Address - Street 2:NICU
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03103-3502
Practice Address - Country:US
Practice Address - Phone:603-663-2692
Practice Address - Fax:603-663-3982
Is Sole Proprietor?:No
Enumeration Date:2009-05-20
Last Update Date:2015-06-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
NH170292080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program