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NPI Code Detail

MEDICARE: MATIAS BLUMETTI APN

MEDICARE: MATIAS BLUMETTI APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LG0600XGerontology Nurse Practitioner26NJ15515700NJ
2363LA2200XAdult Health Nurse Practitioner26NJ15515700NJ

General Provider Information

NPI Number : 1053260497
Entity Type Code : Individual
Provider Name (Legal Business Name) : MATIAS BLUMETTI APN
Provider Business Mailing Address
First Line : 224 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2168
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 224 HAMBURG TPKE
Second Line :
City : WAYNE
State : NJ
Zip : 07470-2168
Country : US
Telephone Number : 973-942-6900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2026
Last Update Date : 01/27/2026

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