Individual
DR. HEATHER MELISSA MATOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6 WELLNESS WAY STE 102, LATHAM, NY 12110-2156
(518) 713-2099
(518) 783-7506
Mailing address
6 WELLNESS WAY STE 201, LATHAM, NY 12110-2156
(518) 782-3700
(518) 782-3799
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
279477
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04237101
—
NY
01
—
63234
ALBANY MEDICAL CENTER ID #
—
Enumeration date
04/24/2012
Last updated
02/08/2024
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