Individual
SAMY MATTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1932 GROVE ST APT 2, RIDGEWOOD, NY 11385-2795
(929) 290-4162
Mailing address
1932 GROVE ST APT 2, RIDGEWOOD, NY 11385-2795
(929) 290-4162
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
P116973
NY
Other
Enumeration date
09/06/2022
Last updated
09/06/2022
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