Provider Demographics
NPI:1831907104
Name:NUNEZ, MATTHEW DARIAN (PHARMD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DARIAN
Last Name:NUNEZ
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5631 NY-12
Mailing Address - Street 2:
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815
Mailing Address - Country:US
Mailing Address - Phone:607-336-2588
Mailing Address - Fax:
Practice Address - Street 1:5631 NY-12
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815
Practice Address - Country:US
Practice Address - Phone:607-336-2588
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-19
Last Update Date:2024-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY072336183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist