Healthcare Provider Details

I. General information

NPI: 1699700351
Provider Name (Legal Business Name): SVETLANA S MATAYEV MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FRANKLIN AVE
VALLEY STREAM NY
11580-2161
US

IV. Provider business mailing address

300 FRANKLIN AVE
VALLEY STREAM NY
11580-2161
US

V. Phone/Fax

Practice location:
  • Phone: 516-599-8280
  • Fax: 516-706-9599
Mailing address:
  • Phone: 516-599-8280
  • Fax: 516-706-9599

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number236272
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number175210
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: