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NPI Code Detail

MEDICARE: NOAH B MATILSKY M.D.

MEDICARE: NOAH B MATILSKY M.D.
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 Physician0101262184VA
22084P0804XChild & Adolescent Psychiatry PhysicianME123938FL
32084P0800XPsychiatry PhysicianME164516FL
42084P0800XPsychiatry PhysicianME123938FL
52084P0804XChild & Adolescent Psychiatry Physician0101262184VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427315126
Entity Type Code : Individual
Provider Name (Legal Business Name) : NOAH B MATILSKY M.D.
Provider Business Mailing Address
First Line : 667 KINGSBOROUGH SQ STE 101
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-4999
Country : US
Telephone Number : 757-842-4481
Fax Number :
Provider Business Practice Location Address
First Line : 736 BATTLEFIELD BLVD N
Second Line :
City : CHESAPEAKE
State : VA
Zip : 23320-4941
Country : US
Telephone Number : 757-312-6754
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/19/2012
Last Update Date : 12/15/2025

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Directions to “ NOAH B MATILSKY M.D.” Practice Location

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