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General NPI Number Information
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NPI Number | 1922339696
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Entity Type | Individual
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Provider Name | JEHAN ASIS MATOZA PT
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Gender | Female
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Dates
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Enumeration Date | 01/20/2010
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Last Update Date | 04/07/2025
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Provider Practice Location Address
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Address Line | 1156 BOWMAN RD UNIT 105
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City | MT PLEASANT
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State | SC
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Zip | 29464-3803
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Country | US
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Telephone | 877-407-3422
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Fax | 877-407-4329
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Provider Business Mailing Address
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Address Line | 1628 JOHN F KENNEDY BLVD SUITE 401
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City | PHILADELPHIA
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State | PA
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Zip | 19103-2125
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Country | US
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Telephone | 215-557-0057
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Fax | 215-557-0061
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 049571
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License Number State | NY
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