Individual
MRS. CHRISTINE ANN MATIJAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
60 MAIN STREET, PORT BYRON, NY 13140
(315) 776-9700
Mailing address
60 MAIN ST., PORT BYRON, NY 13140
(315) 497-1013
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
331655
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01752616
—
NY
Enumeration date
07/25/2006
Last updated
12/18/2014
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