Individual
ANA MERCEDES MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
880 MORRIS AVE, BRONX, NY 10451-3412
(718) 665-9340
(718) 665-2394
Mailing address
880 MORRIS AVE, BRONX, NY 10451-3412
(718) 665-9340
(718) 665-2394
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9862
NYS CASAC
NY
Enumeration date
11/19/2015
Last updated
02/08/2016
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