# RM NP IN ADULT HEALTH P C

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

## Provider details

- **NPI number:** 1548072036
- **Authorized official:** RIGINA MATATOVA NP (OWNER)
- **Authorized official phone:** (917) 361-9333

## Contact information

- **Practice address:** 6535 QUEENS BLVD STE 200, WOODSIDE, NY 11377-5769
- **Practice address phone:** (718) 426-4242
- **Mailing address:** 6535 QUEENS BLVD STE 200, WOODSIDE, NY 11377-5769
- **Mailing address phone:** (718) 426-4242

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LA2200X | Adult Health Nurse Practitioner | — | NULL | Yes |
| 363LA2200X | Adult Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 01/22/2025
- **Last updated:** 01/22/2025