Provider Demographics
NPI:1467897215
Name:MATHIAS, CORY MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:CORY
Middle Name:MICHAEL
Last Name:MATHIAS
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Gender:M
Credentials:DO
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Mailing Address - Street 1:908 NIAGARA FALLS BLVD STE 208
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2019
Mailing Address - Country:US
Mailing Address - Phone:716-692-3302
Mailing Address - Fax:933-953-2016
Practice Address - Street 1:406 FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:SMETHPORT
Practice Address - State:PA
Practice Address - Zip Code:16749-1277
Practice Address - Country:US
Practice Address - Phone:814-887-5655
Practice Address - Fax:814-887-1911
Is Sole Proprietor?:No
Enumeration Date:2013-05-07
Last Update Date:2020-03-30
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Provider Licenses
StateLicense IDTaxonomies
NE1288207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine