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Individual

DR. MARK A MATLOFF

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
409 STANDISH DRIVE, SYRACUSE, NY 13224
(315) 446-3101
(315) 446-3101
Mailing address
409 STANDISH DRIVE, SYRACUSE, NY 13224

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
0068291
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00639134
NY
01
392974
MVP
NY
01
5068296B
WORKERS COMPENSATION BOAR
NY
Enumeration date
10/31/2006
Last updated
07/08/2007
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