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General NPI Number Information
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NPI Number | 1083678429
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Entity Type | Individual
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Provider Name | MICHELE A MATALA ANP/FNP
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Gender | Female
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 12/31/2025
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Provider Practice Location Address
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Address Line | 2731 TRANSIT RD STE 107
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City | ELMA
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State | NY
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Zip | 14059
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Country | US
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Telephone | 716-677-4178
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Fax | 855-816-9607
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Provider Business Mailing Address
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Address Line | 2731 TRANSIT RD STE 107
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City | ELMA
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State | NY
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Zip | 14059
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Country | US
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Telephone | 716-677-4178
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Fax | 855-816-9607
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | F302546-1
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License Number State | NY
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