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NPI Code Detail

MEDICARE: MS. SAMANTHA JEAN MATZIO NP

MEDICARE: MS. SAMANTHA JEAN MATZIO NP
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
1363LF0000XFamily Nurse PractitionerF343111NY

General Provider Information

NPI Number : 1881170884
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SAMANTHA JEAN MATZIO NP
Provider Business Mailing Address
First Line : 135 MINEOLA BLVD FL 2
Second Line :
City : MINEOLA
State : NY
Zip : 11501-3917
Country : US
Telephone Number : 917-310-3371
Fax Number : 516-938-1554
Provider Business Practice Location Address
First Line : 3959 BROADWAY
Second Line :
City : NEW YORK
State : NY
Zip : 10032-1559
Country : US
Telephone Number : 917-515-8107
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/13/2018
Last Update Date : 04/06/2026

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