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Individual

MELISSA DIANE MATTIMORE I

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, ACNP

Contact information

Practice address
1190 5TH AVE, BOX 1458, NEW YORK, NY 10029-6503
(917) 538-2769
Mailing address
1190 5TH AVE, BOX 1458, NEW YORK, NY 10029-6503
(917) 538-2769

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
F430405-1
NY

Other

Enumeration date
07/09/2008
Last updated
01/14/2011
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