Organization
MATRIX MEDICAL OF NEW YORK PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE PETERSON (MANAGER CREDENTIALING)
(877) 564-3627
Entity
Organization
Contact information
Practice address
1740 BROADWAY, NEW YORK, NY 10019-4315
(480) 862-1677
(480) 718-7643
Mailing address
424 CHURCH ST STE 220, NASHVILLE, TN 37219-2464
(877) 564-3627
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/29/2012
Last updated
10/09/2025
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