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NPI Code Detail

MEDICARE: ANGELINA H MATAMALA

MEDICARE: ANGELINA H MATAMALA
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
1106S00000XBehavior TechnicianVA

General Provider Information

NPI Number : 1821943770
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGELINA H MATAMALA
Provider Business Mailing Address
First Line : 10110 MAKELYS WAY
Second Line :
City : MANASSAS
State : VA
Zip : 20110-6063
Country : US
Telephone Number : 570-320-3390
Fax Number :
Provider Business Practice Location Address
First Line : 225 BROADHOLLOW RD STE 402
Second Line :
City : MELVILLE
State : NY
Zip : 11747-4899
Country : US
Telephone Number : 631-385-7780
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2026
Last Update Date : 03/04/2026

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Directions to “ ANGELINA H MATAMALA ” Practice Location

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