Individual
DR. NICOLE MATAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1 BLACHLEY RD, STAMFORD, CT 06902-0002
(203) 705-0948
(203) 705-0938
Mailing address
PO BOX 626, GREAT RIVER, NY 11739-0626
(631) 892-2745
(631) 201-3179
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
25MA11138600
NJ
207LP2900X
Pain Medicine (Anesthesiology) Physician
302738
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
79958
CT
Other
Enumeration date
03/22/2016
Last updated
04/18/2025
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