Provider Demographics
NPI:1942528997
Name:O'CONNOR, MATTHEW CROSBY (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:CROSBY
Last Name:O'CONNOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 PROSPECT AVE
Mailing Address - Street 2:PEDIATRIX MEDICAL GROUP
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13203-1807
Mailing Address - Country:US
Mailing Address - Phone:315-448-5287
Mailing Address - Fax:315-448-6167
Practice Address - Street 1:301 PROSPECT AVE
Practice Address - Street 2:PEDIATRIX MEDICAL GROUP
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13203-1807
Practice Address - Country:US
Practice Address - Phone:315-448-5287
Practice Address - Fax:315-448-6167
Is Sole Proprietor?:No
Enumeration Date:2010-05-13
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY284031-12080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine