MEDICARE: JEFFREY AARON MATOS M.D

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
1	207RC0001X	Clinical Cardiac Electrophysiology Physician	142410	NY

General Provider Information

NPI Number	:	1548214331
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY AARON MATOS M.D

Provider Business Mailing Address
First Line	:	1421 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-1802
Country	:	US
Telephone Number	:	212-772-6384
Fax Number	:	212-772-1674

Provider Business Practice Location Address
First Line	:	1421 3RD AVE
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10028-1802
Country	:	US
Telephone Number	:	212-772-6384
Fax Number	:	212-772-1674

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	03/03/2010

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