Individual
DANA MATERIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANCC
Contact information
Practice address
1147 RICHMOND RD, STATEN ISLAND, NY 10304-2423
(718) 816-9056
(718) 816-1165
Mailing address
1 EDGEWATER ST, 6TH FL, STATEN ISLAND, NY 10305-4900
(718) 226-1047
(718) 226-1039
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
F334092
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02427301
—
NY
Enumeration date
11/22/2005
Last updated
05/13/2010
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