Individual
JESSICA MATOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4230 HEMPSTEAD TPKE STE 106, BETHPAGE, NY 11714-5700
(631) 374-6398
Mailing address
9 FALCON CT, FARMINGVILLE, NY 11738-1903
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
007000
NY
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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