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Individual

RICARDO MATIENZO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
450 7TH ST, SUITE 9, HOBOKEN, NJ 07030-2057
(201) 659-0711
(201) 659-4117
Mailing address
450 7TH ST, SUITE 9, HOBOKEN, NJ 07030-2057
(201) 659-0711
(201) 659-4117

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MA075238
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9033009
NJ
Enumeration date
10/03/2005
Last updated
09/06/2012
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