Provider Demographics
NPI:1255353801
Name:MATSUO, YOSHIRO (MD)
Entity type:Individual
Prefix:DR
First Name:YOSHIRO
Middle Name:
Last Name:MATSUO
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:ONE FOXCARE DRIVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:ONEONTA
Mailing Address - State:NY
Mailing Address - Zip Code:13820
Mailing Address - Country:US
Mailing Address - Phone:607-432-6291
Mailing Address - Fax:607-431-5191
Practice Address - Street 1:ONE FOXCARE DRIVE
Practice Address - Street 2:SUITE 310
Practice Address - City:ONEONTA
Practice Address - State:NY
Practice Address - Zip Code:13820
Practice Address - Country:US
Practice Address - Phone:607-432-6291
Practice Address - Fax:607-431-5191
Is Sole Proprietor?:No
Enumeration Date:2006-07-24
Last Update Date:2009-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097268207RH0003X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00279098Medicaid
NY00279098Medicaid
B82023Medicare UPIN