Organization
AMERICAN TELEPSYCHIATRY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DARREN MATAVKA (VICE PRESIDENT)
(414) 376-5577
Entity
Organization
Contact information
Practice address
5408 W BURLEIGH ST, MILWAUKEE, WI 53210-1624
(414) 376-5577
(414) 446-3803
Mailing address
4650 S HOWELL AVE, MILWAUKEE, WI 53207-5906
(414) 376-5577
(414) 301-6381
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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