Individual
MISS NICOLE LYNN MATTES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., RPA-C
Contact information
Practice address
301 PROSPECT AVE, SYRACUSE, NY 13203-1807
(315) 448-5111
(315) 703-5079
Mailing address
104 UNION AVE, SUITE 804, SYRACUSE, NY 13203-1843
(315) 703-5049
(315) 703-5079
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
013801
NY
Other
Enumeration date
01/13/2010
Last updated
07/18/2013
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