Matises, Amanda Emily

Matises, Amanda Emily is an individual health care provider with primary practice located at 669 Broadway , Massapequa NY 11758-2314. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics, which is considered as her primary health care specialty. Matises, Amanda Emily can be contacted via phone (516) 799-2900.

Contact Information

Primary practice address
669 Broadway Massapequa NY 11758-2314
Phone: (516) 799-2900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics 225XP0200X

Profile Details

NPI number 1033732060
LBN Legal business name Matises, Amanda Emily
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2020
Last updated Nov 27th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033732060 NPPES
New York Other 024614 NYS OT LICENCE

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