Healthcare Provider Details

I. General information

NPI: 1477568343
Provider Name (Legal Business Name): ROBERT MATALON MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

323 E 34TH ST
NEW YORK NY
10016-4974
US

IV. Provider business mailing address

317 E 34TH ST
NEW YORK NY
10016-4974
US

V. Phone/Fax

Practice location:
  • Phone: 212-889-0770
  • Fax: 212-725-3538
Mailing address:
  • Phone: 212-889-0770
  • Fax: 212-725-3538

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. ROBERT MATALON
Title or Position: DIRECTOR
Credential: MD
Phone: 212-889-0770