Individual
DEREK MATTESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.N.
Contact information
Practice address
42 CAPE RD, MILFORD, MA 01757-3292
(800) 853-2288
Mailing address
100 BULLOCKS POINT AVE, RIVERSIDE, RI 02915-5351
(401) 437-1008
(401) 433-3042
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN2341300
MA
163WD0400X
Diabetes Educator Registered Nurse
RN53309
RI
Other
Enumeration date
10/31/2016
Last updated
04/13/2020
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