Basic Information
| Provider Information | |||||||||
| NPI: | 1326152489 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHIRALLI | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | PERRY | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 360 LINDEN OAKS DRIVE | ||||||||
| Address2: | SUITE #300 | ||||||||
| City: | ROCHESTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 146252806 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5853838830 | ||||||||
| FaxNumber: | 5853838901 | ||||||||
| Practice Location | |||||||||
| Address1: | 4 COULTER RD STE 2605 | ||||||||
| Address2: | |||||||||
| City: | CLIFTON SPRINGS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 144321122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3154622636 | ||||||||
| FaxNumber: | 3154622638 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/18/2006 | ||||||||
| LastUpdateDate: | 04/16/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/16/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 249047-1 | NY | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 03604684 | 05 | NY | MEDICAID |