Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RH0003X | Hematology & Oncology | MA76765 | NJ |
Y | 207RH0003X | Hematology & Oncology | MD424888 | PA |
N | 207RH0003X | Hematology & Oncology | MT179888 | PA |
NPI | 1053473983 |
---|---|
Provider Name | Anthony R. Mato |
First Address | Philadelphia, PA 19104-5127 |
Second Address | Philadelphia, PA 19104-5127 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2006 |
Last Update Date | 26/12/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0166260 | (05) | NJ |