Provider Demographics
NPI:1326595547
Name:W. MATTHEW WHITE, MD, PLLC
Entity Type:Organization
Organization Name:W. MATTHEW WHITE, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:WHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:646-957-7207
Mailing Address - Street 1:800A 5TH AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-7215
Mailing Address - Country:US
Mailing Address - Phone:646-957-7207
Mailing Address - Fax:646-568-7171
Practice Address - Street 1:800A 5TH AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-7215
Practice Address - Country:US
Practice Address - Phone:646-957-7207
Practice Address - Fax:646-568-7171
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-06
Last Update Date:2016-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY24901207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic AllergyGroup - Single Specialty