MEDICARE: DR. FRANK JOSEPH MATONE PH.D,DHS,LCSW

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	1041C0700X	Clinical Social Worker	44SC05162300	NJ

General Provider Information

NPI Number	:	1710475827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FRANK JOSEPH MATONE PH.D,DHS,LCSW

Provider Business Mailing Address
First Line	:	1267 ANDERSON AVE APT 9
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-1753
Country	:	US
Telephone Number	:	201-450-8566
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 WEST ST
Second Line	:
City	:	FORT LEE
State	:	NJ
Zip	:	07024-5028
Country	:	US
Telephone Number	:	201-450-8566
Fax Number	:

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

Provider Enumeration Date	:	04/24/2018
Last Update Date	:	04/24/2018

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