Individual
MIGUEL MATEO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
687 FRELINGHUYSEN AVE, NEWARK, NJ 07114-1349
(973) 799-0508
Mailing address
2013 PRINCESS CT # 2013, WOODBRIDGE, NJ 07095-3800
(908) 380-7065
Taxonomy
Speciality
Code
Description
License number
State
103TA0400X
Addiction (Substance Use Disorder) Psychologist
Primary
NJDCATEMP
NJ
Other
Enumeration date
04/22/2020
Last updated
04/22/2020
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