Provider Demographics
NPI:1528038239
Name:WILLIAMS, MATTHEW A (PT DPT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:A
Last Name:WILLIAMS
Suffix:
Gender:M
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2333 N MAIN ST
Mailing Address - Street 2:PO BOX 412
Mailing Address - City:WARSAW
Mailing Address - State:NY
Mailing Address - Zip Code:14569
Mailing Address - Country:US
Mailing Address - Phone:585-786-8700
Mailing Address - Fax:585-786-2659
Practice Address - Street 1:56 MAIN ST
Practice Address - Street 2:STEP BY STEP PHYSICAL THERAPY
Practice Address - City:AKRON
Practice Address - State:NY
Practice Address - Zip Code:14001
Practice Address - Country:US
Practice Address - Phone:716-542-1135
Practice Address - Fax:716-542-9931
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023362225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000626892002OtherBCBS OF WESTERN NEW YORK
NY02275065Medicaid
P62468Medicare UPIN
NYDD1585Medicare ID - Type Unspecified