MEDICARE: MISS DESERIE MATOS I LCSW

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
1	1041C0700X	Clinical Social Worker	R046582-01	NY

General Provider Information

NPI Number	:	1285348292
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS DESERIE MATOS I LCSW

Provider Business Mailing Address
First Line	:	PO BOX 260054
Second Line	:
City	:	BELLEROSE
State	:	NY
Zip	:	11426-0054
Country	:	US
Telephone Number	:	347-557-2293
Fax Number	:

Provider Business Practice Location Address
First Line	:	22427 MANOR RD
Second Line	:
City	:	QUEENS VILLAGE
State	:	NY
Zip	:	11427-2005
Country	:	US
Telephone Number	:	347-557-2293
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2023
Last Update Date	:	01/13/2023

Similar Medicare Providers

1871444802 — MS. CANDICE HAMER NP
Practice Location Address:

22415 MANOR RD
QUEENS VILLAGE, NY
11427-2005

Practice Phone: 646-335-5543
Practice Fax:

1164019964 — EVA JEWAT
Practice Location Address:

22433 MANOR RD
QUEENS VILLAGE, NY
11427-2005

Practice Phone: 718-506-7161
Practice Fax:

1467921304 — MR. JOSHUA ALAN ZEIGLER MS BCBA
Practice Location Address:

54 QUEENS BRIDGE RD
LEVITTOWN, PA
19057-2005

Practice Phone: 717-448-0283
Practice Fax:

1033160320 — WOODFIELD UROLOGY PARTNERSHIP
Practice Location Address:

800 BIESTERFIELD RD , BROCK #2005
ELK GROVE VILLAGE, IL
60007-3311

Practice Phone: 847-364-4990
Practice Fax: 847-364-4993

1164740270 — WOODFIELD UROLOGY
Practice Location Address:

800 BIESTERFIELD RD , SUITE 2005
ELK GROVE VILLAGE, IL
60007-3364

Practice Phone: 847-364-4990
Practice Fax: 847-364-4993

1366851974 — DR. MATTHEW D. ZAWILENSKI MD SC
Practice Location Address:

800 BIESTERFIELD RD , SUITE 2005
ELK GROVE VILLAGE, IL
60007-3361

Practice Phone: 847-708-6014
Practice Fax:

Directions to “ MISS DESERIE MATOS I LCSW” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.