Provider Demographics
NPI:1639136682
Name:CYWINSKI, MATTHEW J (MD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:CYWINSKI
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 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8235
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:295 ESSJAY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8216
Practice Address - Country:US
Practice Address - Phone:716-834-4237
Practice Address - Fax:716-834-3639
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY206063-1208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY161000580OtherNORTH AMERICAN PREFERED
NY161000580OtherEMPIRE
NY0021748OtherGHI
NY000524692002OtherHEALTH NOW
NY01843425Medicaid
NY1409274OtherIHA
NY206063-0BOtherWORKERS COMPENSATION
NY280000943OtherRR MEDICARE
NY161000580OtherAETNA
NY0021748OtherGHI
NYBB6059Medicare PIN