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Individual

NICOLE CHRISTINE MATOCHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
9005 OLD RIVER RD, MARCY, NY 13403-3000
(315) 765-3278
Mailing address
9005 OLD RIVER RD, MARCY, NY 13403-3000

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
402212
NY

Other

Enumeration date
08/16/2017
Last updated
09/03/2019
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