Individual
DR. COLLEEN A MATTIMORE
Active
Individual
DR. COLLEEN A MATTIMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
194429
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00010113101
UNIVERA HEALTHCARE
NY
01
—
000523597001
BLUE CROSS BLUE SHIELD
NY
05
—
01559897
—
NY
01
—
1207139
INDEPENDENT HEALTH
NY
Enumeration date
01/31/2006
Last updated
06/30/2026
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