Provider Demographics
NPI:1245669670
Name:PRIONAS, MATTHEW JOHN AUGUST (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:JOHN AUGUST
Last Name:PRIONAS
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DR, ATTEN: BECKI H
Mailing Address - Street 2:
Mailing Address - City:MASSENA
Mailing Address - State:NY
Mailing Address - Zip Code:13662-1056
Mailing Address - Country:US
Mailing Address - Phone:315-769-4317
Mailing Address - Fax:315-769-4353
Practice Address - Street 1:181 MAPLE ST STE A
Practice Address - Street 2:
Practice Address - City:MASSENA
Practice Address - State:NY
Practice Address - Zip Code:13662-1052
Practice Address - Country:US
Practice Address - Phone:315-769-4704
Practice Address - Fax:315-842-3035
Is Sole Proprietor?:No
Enumeration Date:2013-11-06
Last Update Date:2019-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY285094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04600684Medicaid