Individual
MRS. ELAINE MARIE MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
1521 JARRET PL, BRONX, NY 10461-2606
(718) 862-8840
Mailing address
1521 JARRETT PLACE, BRONX, NY 10461-2606
(718) 862-8840
Taxonomy
Speciality
Code
Description
License number
State
163WX0003X
Inpatient Obstetric Registered Nurse
577356-1
NY
363LF0000X
Family Nurse Practitioner
Primary
F336629-1
NY
Other
Enumeration date
08/02/2011
Last updated
09/06/2012
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