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General NPI Number Information
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NPI Number | 1104133750
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Entity Type | Individual
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Provider Name | MATTHEW KEONI TWOMEY N.P.
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Gender | Male
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Dates
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Enumeration Date | 09/02/2010
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 1199 PARK AVE
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City | NEW YORK
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State | NY
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Zip | 10128-1711
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Country | US
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Telephone | 212-828-7473
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Fax |
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Provider Business Mailing Address
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Address Line | 625 MOONDALE DR
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City | EL PASO
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State | TX
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Zip | 79912-4237
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Country | US
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Telephone |
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Fax | 401-561-2577
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 406442
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 2264827
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License Number State | MA
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