Basic Information
| Provider Information | |||||||||
| NPI: | 1316324981 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TAYLOR | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 ELMWOOD AVE BOX 675 | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146420001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852754517 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 601 ELMWOOD AVE | ||||||||
| Address2: | |||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146423011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5852754517 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/02/2015 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 07/21/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 292595 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | MD194166 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 194166 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 292595 | NY | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 208M00000X | 292595 | NY | N | Allopathic & Osteopathic Physicians | Hospitalist |
No ID Information.