Provider Demographics
NPI:1679808489
Name:BUFFAN, MATTHEW J (DC)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:BUFFAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:121 SULLYS TRL STE 7
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4570
Mailing Address - Country:US
Mailing Address - Phone:585-678-1362
Mailing Address - Fax:585-419-7048
Practice Address - Street 1:121 SULLYS TRL STE 7
Practice Address - Street 2:
Practice Address - City:PITTSFORD
Practice Address - State:NY
Practice Address - Zip Code:14534-4570
Practice Address - Country:US
Practice Address - Phone:585-678-1362
Practice Address - Fax:585-419-7048
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY011867111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation