Provider Demographics
NPI:1386974467
Name:MATSON, BENJAMIN L (MD)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:L
Last Name:MATSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BENJAMIN
Other - Middle Name:L
Other - Last Name:MATSON
Other - Suffix:IV
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:ELM AND CARLTON SREETS
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14263-0001
Mailing Address - Country:US
Mailing Address - Phone:716-845-2300
Mailing Address - Fax:
Practice Address - Street 1:ELM AND CARLTON STREETS
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14263-0001
Practice Address - Country:US
Practice Address - Phone:716-845-2300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-12
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY282400207LP2900X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine