Organization
THOMAS J. MATA SSA, P.T., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS JOSEPH MATASSA P.T. (PRESIDENT)
(718) 281-2861
Entity
Organization
Contact information
Practice address
44-27 DOUGLASTON PARKWAY, DOUGLASTON, NY 11363
(718) 281-2861
(718) 281-0173
Mailing address
44-27 DOUGLASTON PARKWAY, DOUGLASTON, NY 11363
(718) 281-2861
(718) 281-0173
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
012203
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Q78781
MEDICARE PROVIDER NUMBER
NY
01
—
Q78782
MEDICARE PROVIDER NUMBER
NY
Enumeration date
01/21/2009
Last updated
01/23/2023
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