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Contact Information

MATTISON A BURT, MD
101 DATES DRIVE
ITHACA, NY14850
 Phone: 607-274-4011
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for MATTISON A BURT · (Male)

NPI Number 1437129483
Status Active
Credentials MD
Entity Individual
Enumeration date 01/24/2006
Last updated 11/14/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • NY License # 207761
  • NY Medicaid 01775433
Hospital affiliation(s)
  • CAYUGA MEDICAL CENTER AT ITHACA - (Acute Care)
    101 DATES DRIVE
    ITHACA, NY 14850
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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