Individual
KATY MABUNAY MATILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
140 PARK AVE, FLORHAM PARK, NJ 07932-1049
(973) 718-5800
(973) 829-4332
Mailing address
1 DIAMOND HILL RD, BERKELEY HEIGHTS, NJ 07922-2104
(908) 273-4300
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
26NJ14944800
NJ
367500000X
Certified Registered Nurse Anesthetist
881444
NY
367500000X
Certified Registered Nurse Anesthetist
95001614
CA
Other
Enumeration date
12/02/2021
Last updated
08/14/2024
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