Organization
MATAYBO MEDICAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY BLACKETT-BONNETT M.D. (ADMINISTRATIVE PARTNER)
(718) 230-4200
Entity
Organization
Contact information
Practice address
1236 FULTON ST, BROOKLYN, NY 11216-2093
(718) 230-4200
(718) 230-4277
Mailing address
1236 FULTON ST, BROOKLYN, NY 11216-2093
(718) 230-4200
(718) 230-4277
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
05/26/2008
Last updated
05/26/2008
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