| Doctor Name: | DR. MATTHEW CHARLES KRUPPENBACHER |
| NPI Number: | 1477999803 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 208D00000X |
| Business Practice Address: | 2157 Main St Buffalo, NY - 142142648 |
| Business Phone Number: | 7168621840 |
| Business Fax Number: | |
| Mailing Address: | 2157 Main St, BUFFALO |
| State: | NY |
| Postal Code: | 142142648 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/13/2013 |
| NPI Last Update Date: | 05/13/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 208D00000X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |