Basic Information
Provider Information
NPI: 1922289883
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PARAYIL
FirstName: MATHEW
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2094 ALBANY POST RD
Address2:  
City: MONTROSE
State: NY
PostalCode: 105481454
CountryCode: US
TelephoneNumber: 9147374400
FaxNumber: 9147374400
Practice Location
Address1: 2094 ALBANY POST RD
Address2:  
City: MONTROSE
State: NY
PostalCode: 105481454
CountryCode: US
TelephoneNumber: 9147374400
FaxNumber: 9147374400
Other Information
ProviderEnumerationDate: 11/20/2007
LastUpdateDate: 02/19/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X253744-1NYN Allopathic & Osteopathic PhysiciansFamily Medicine 
207QG0300X253744-1NYY Allopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine

No ID Information.


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