Individual
DR. IRENE MATIATOS
Active
Individual
DR. IRENE MATIATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Taxonomy
Speciality
Code
Description
License number
State
103TB0200X
Cognitive & Behavioral Psychologist
010778-1
NY
103TC0700X
Clinical Psychologist
010778-1
NY
103TC0700X
Clinical Psychologist
Primary
3902
NC
103TF0000X
Family Psychologist
010778-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
386523
MVP
NY
01
—
6802210
GHI
NY
01
—
P570970
OXFORD
NY
01
—
S10778
WORKERS COMPENSATION
NY
Enumeration date
11/15/2006
Last updated
09/23/2010
Update your record
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