Individual
GRACE MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
ONE NORTH GALLERIA DRIVE, MIDDLETOWN, NY 10941
(845) 845-6920
Mailing address
38 SESAME ST, ROCK TAVERN, NY 12575-5529
(845) 496-1094
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T005638-1
NY
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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