Individual
MARY E MATACCHIERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
12 PETRA LN, ALBANY, NY 12205-4973
(518) 452-0445
(518) 452-3489
Mailing address
4 CATALPA DR, ALBANY, NY 12209-1604
(518) 434-4721
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
304346
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
304346
RN LICENSE
NY
Enumeration date
03/23/2007
Last updated
07/08/2007
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