Provider Demographics
NPI:1013274208
Name:KRATOCHVIL, MATTHEW JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JAMES
Last Name:KRATOCHVIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:119 COGGESHALL ST
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02746-2443
Mailing Address - Country:US
Mailing Address - Phone:508-990-1900
Mailing Address - Fax:
Practice Address - Street 1:6 FOUNTAIN PLZ
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14202-2211
Practice Address - Country:US
Practice Address - Phone:716-691-8838
Practice Address - Fax:716-534-1134
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-12
Last Update Date:2018-02-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY274784207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine