Nicole Christine Matocha
Nurse Practitioner - Psychiatric/Mental Health
9005 Old River Rd
Marcy
, New York 13403-3000
Nicole Christine Matocha
Nurse Practitioner - Psychiatric/Mental Health
9005 Old River Rd
Marcy
, New York 13403-3000
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About
Features
Specialties
- Nurse Practitioner - Psychiatric/Mental Health
Languages spoken
- English
Location
First Address
- Nicole Christine Matocha
- 9005 Old River Rd
- Marcy, NY
- Zip : 13403-3000
- Phone :
Second Address
- Nicole Christine Matocha
- 9005 Old River Rd
- Marcy, NY
- Zip : 13403-3000
- Phone : (315) 765-3278
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | 402212 | NY |
National Provider Identifier
| NPI | 1013433606 |
|---|---|
| Provider Name | Nicole Christine Matocha |
| First Address | Marcy, NY 13403-3000 |
| Second Address | Marcy, NY 13403-3000 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 16/08/2017 |
| Last Update Date | 03/09/2019 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.