Individual
LUCAS DA MATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 265-3300
Mailing address
50 LEROY ST, POTSDAM, NY 13676-1786
(315) 265-3300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
336863
NY
207R00000X
Internal Medicine Physician
125.075728
IL
2084N0400X
Neurology Physician
125.075728
IL
Other
Enumeration date
05/04/2020
Last updated
10/07/2025
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