Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 008978-1 | NY |
Y | 103T00000X | Psychologist | 008978-1 | NY |
N | 103TB0200X | Cognitive & Behavioral Psychologist | ||
N | 103G00000X | Clinical Psychologist | 008978-1 | NY |
N | 103TC0700X | Clinical Psychologist | 008978-1 | NY |
N | 103TS0200X | School Psychologist |
NPI | 1114103157 |
---|---|
Provider Name | Dr. Robert Matuozzi |
First Address | Babylon, NY 11702-3531 |
Second Address | Babylon, NY 11702-3531 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2008 |
Last Update Date | 19/01/2008 |