# CITY MEDICAL PHYSICIAN PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1265299044
- **Authorized official:** AYMAN MATTA (OWNER)
- **Authorized official phone:** (845) 652-0151

## Contact information

- **Practice address:** 417 E 138TH ST, BRONX, NY 10454-3004
- **Practice address phone:** (845) 359-7272
- **Practice address fax:** (845) 359-7388
- **Mailing address:** 99 DUTCH HILL RD, ORANGEBURG, NY 10962-2185
- **Mailing address phone:** (845) 359-7272
- **Mailing address fax:** (845) 359-7388

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/28/2024
- **Last updated:** 04/03/2024