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NPI Code Detail

MEDICARE: MARY REYNAGA MATONE RD

MEDICARE: MARY REYNAGA MATONE RD
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1558950444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY REYNAGA MATONE RD
Provider Business Mailing Address
First Line : 33-41 NEWARK ST FL 5
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5627
Country : US
Telephone Number : 917-647-1665
Fax Number : 201-473-5812
Provider Business Practice Location Address
First Line : 33-41 NEWARK ST FL 5
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-5627
Country : US
Telephone Number : 917-647-1665
Fax Number : 201-473-5812
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/14/2021
Last Update Date : 01/13/2026

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Directions to “ MARY REYNAGA MATONE RD” Practice Location

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