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1366497661

NPI Code Detail

MEDICARE: DR. ROVETTA MARIE MATTIA OD

MEDICARE: DR. ROVETTA MARIE MATTIA OD

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	152W00000X	Optometrist	3329	CT
2	152W00000X	Optometrist	009972	NY
3	152W00000X	Optometrist	I5-0000004	DE
4	152W00000X	Optometrist	1509	NH
5	152W00000X	Optometrist	OPT-002655	AZ
6	152W00000X	Optometrist	TPOP149	FL
7	152W00000X	Optometrist	RQ004081	MI
8	152W00000X	Optometrist	4901004081	MI

General Provider Information

NPI Number	:	1366497661
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROVETTA MARIE MATTIA OD

Provider Business Mailing Address
First Line	:	7230 ORCHARD LAKE RD
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-3603
Country	:	US
Telephone Number	:	248-661-5100
Fax Number	:	215-661-8816

Provider Business Practice Location Address
First Line	:	735 JOHN R RD STE 150
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48083-5859
Country	:	US
Telephone Number	:	248-577-3659
Fax Number	:	248-588-9917

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	12/16/2025

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Directions to “ DR. ROVETTA MARIE MATTIA OD” 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.

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