Individual
MR. MICHAEL MARTIN MATIAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CASAC 8616
Contact information
Practice address
211 BROWN PL, BRONX, NY 10454-4109
(917) 567-5007
(718) 503-7751
Mailing address
211 BROWN PL, BRONX, NY 10454-4109
(917) 567-5007
(718) 503-7751
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
8116
NY
Other
Enumeration date
01/28/2009
Last updated
01/28/2009
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