Individual
MR. MARCO J MATEJKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
3401 N BROAD ST, PHILADELPHIA, PA 19140-5103
(215) 707-3326
(215) 707-8028
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 766-7811
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN221131-L
PA
367500000X
Certified Registered Nurse Anesthetist
035825
PA
367500000X
Certified Registered Nurse Anesthetist
Primary
RN221131L
PA
Other
Enumeration date
05/29/2008
Last updated
05/23/2018
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