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General NPI Number Information
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NPI Number | 1518031160
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Entity Type | Individual
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Provider Name | MATTHEW LEMASTER APRN
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Gender | Male
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 444 CENTER STREET
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City | MANCHESTER
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State | CT
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Zip | 06040-3926
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Country | US
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Telephone | 860-646-3888
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Fax | 860-645-4132
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Provider Business Mailing Address
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Address Line | 2 WATERSIDE XING STE 401
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City | WINDSOR
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State | CT
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Zip | 06095-1588
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Country | US
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Telephone | 860-731-5522
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Fax | 860-731-5536
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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 | 163WP0808X
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Taxonomy Name | Psychiatric/Mental Health Registered Nurse
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License Number | 71003251A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 364SP0810X
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Taxonomy Name | Child & Family Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 003018
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License Number State | CT
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