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NPI Code Detail

MEDICARE: ALEXA MATOS

MEDICARE: ALEXA MATOS
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1285198622
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEXA MATOS
Provider Business Mailing Address
First Line : 1728 HOBART AVE PH
Second Line :
City : BRONX
State : NY
Zip : 10461-4908
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 535 8TH AVE FL 2
Second Line :
City : NEW YORK
State : NY
Zip : 10018-4332
Country : US
Telephone Number : 212-787-9700
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2019
Last Update Date : 01/30/2019

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Directions to “ ALEXA MATOS ” Practice Location

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