Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 204165 | NY |
NPI | 1033174834 |
---|---|
Provider Name | Albert Matalon |
First Address | New York, NY 10016-4974 |
Second Address | New York, NY 10016-4974 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/04/2006 |
Last Update Date | 16/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
84923DN361 | MEDICARE (01) | NY |
H13523 | (02) | NY |