Individual
BILLIE MATTIOLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5501 OLD YORK RD, PHILADELPHIA, PA 19141-3018
(215) 456-7890
Mailing address
2 N PLAZA PL, ATLANTIC CITY, NJ 08401-3332
(856) 305-5941
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
MA066133
PA
Other
Enumeration date
10/09/2024
Last updated
10/09/2024
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