Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 222412 | NY |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 222412 | NY |
NPI | 1134321722 |
---|---|
Provider Name | Dr. Matthew Edward Cunningham |
First Address | New York, NY 10087-9234 |
Second Address | New York, NY 10021 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 29/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
03245769 | (05) | NY |