Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 310537 | NY |
NPI | 1275298655 |
---|---|
Provider Name | Karolina Matulewicz |
First Address | Long Island City, NY 11101-5871 |
Second Address | New York, NY 10065-6007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2021 |
Last Update Date | 03/02/2022 |