Individual
AMANDA MARIE MATRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
(914) 557-4209
Mailing address
475 SEAVIEW AVE, STATEN ISLAND, NY 10305-3436
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
325278-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2020
Last updated
03/16/2026
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