Individual
MIRABELLE MATTAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1011 VETERANS MEMORIAL PKWY, RIVERSIDE, RI 02915-5061
(401) 432-1000
(401) 432-1500
Mailing address
750 E ADAMS ST, SYRACUSE, NY 13210-2342
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD15792
RI
Other
Enumeration date
07/07/2012
Last updated
03/17/2018
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