Matloff, Mark A

Matloff, Mark A is an individual health care provider with primary practice located at 409 Standish Drive , Syracuse NY 13224. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Matloff, Mark A can be contacted via phone (315) 446-3101.

Contact Information

Primary practice address
409 Standish Drive Syracuse NY 13224
Phone: (315) 446-3101
Fax: (315) 446-3101
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Psychologist 103T00000X 0068291 New York

Profile Details

NPI number 1295811198
LBN Legal business name Matloff, Mark A
Credentials PHD
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 31st, 2006
Last updated Jul 8th, 2007 - about 19 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 1295811198 NPPES
New York Other 5068296B WORKERS COMPENSATION BOAR
New York Other 392974 WORKERS COMPENSATION BOAR
New York MEDICAID 00639134 WORKERS COMPENSATION BOAR

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