MEDICARE: BARBARA MATTHEWS

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	163W00000X	Registered Nurse	560159	NY

General Provider Information

NPI Number	:	1336708783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA MATTHEWS

Provider Business Mailing Address
First Line	:	3330 CORSA AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-2809
Country	:	US
Telephone Number	:	917-951-5373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 CORSA AVE
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10469-2809
Country	:	US
Telephone Number	:	917-951-5373
Fax Number	:

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

Provider Enumeration Date	:	06/10/2019
Last Update Date	:	06/10/2019

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Directions to “ BARBARA MATTHEWS ” Practice Location

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