Individual
MS. LORI M. MATCZAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3975 CONSHOHOCKEN AVE, PHILADELPHIA, PA 19131-5426
(215) 879-1000
(215) 879-3912
Mailing address
843 RISING SUN RD, TELFORD, PA 18969-2125
(215) 368-7000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN261173L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0019272130004
—
PA
Enumeration date
05/03/2007
Last updated
07/08/2007
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