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NPI Code Detail

MEDICARE: DR. AMY MATTERN D.O.

MEDICARE: DR. AMY MATTERN D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry Physician319686NY
22084P0800XPsychiatry Physician34.013645OH

General Provider Information

NPI Number : 1275927139
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. AMY MATTERN D.O.
Provider Business Mailing Address
First Line : 109 W 27TH ST RM 5S
Second Line :
City : NEW YORK
State : NY
Zip : 10001-6208
Country : US
Telephone Number : 833-351-8255
Fax Number : 888-815-3583
Provider Business Practice Location Address
First Line : 1 W WINTER ST STE 200
Second Line :
City : DELAWARE
State : OH
Zip : 43015-4635
Country : US
Telephone Number : 513-828-0285
Fax Number : 888-815-3583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2015
Last Update Date : 04/29/2025

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