Individual
MISS MARIA ELIZABETH MATTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
250 E MAIN ST, BAY SHORE, NY 11706-8442
(631) 390-7100
Mailing address
24 SEABREEZE LN, WEST ISLIP, NY 11795-5051
(631) 252-1921
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F310944-01
NY
Other
Enumeration date
06/27/2023
Last updated
06/27/2023
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