Provider Demographics
NPI:1396966297
Name:MATLIN, ARNOLD HERMAN (MD)
Entity type:Individual
Prefix:
First Name:ARNOLD
Middle Name:HERMAN
Last Name:MATLIN
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 1:2290 ANDERSON ROAD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:14486-9713
Mailing Address - Country:US
Mailing Address - Phone:585-768-2345
Mailing Address - Fax:585-768-7311
Practice Address - Street 1:8250 STATE STREED ROAD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020
Practice Address - Country:US
Practice Address - Phone:585-768-6277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY105139208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics