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Individual

MRS. AMY MATTIELLI

Active
Sole proprietor

Provider details

NPI number
Gender
F
Credential
P.A.-C.

Contact information

Practice address
2454 HYLAN BOULEVARD, STATEN ISLAND, NY 10306
(718) 233-1300
(718) 980-9728
Mailing address
124 CINDY ST, OLD BRIDGE, NJ 08857-3023
(732) 679-1248

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
006636
NY

Other

Enumeration date
02/13/2006
Last updated
07/08/2007
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