Individual
DR. MARSHALL IRA MATOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
140 LOCKWOOD AVENUE, SUITE 310, NEW ROCHELLE, NY 10801-4915
(914) 576-7171
(914) 576-4770
Mailing address
140 LOCKWOOD AVENUE, SUITE 310, NEW ROCHELLE, NY 10801-4915
(914) 576-7171
(914) 840-1112
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
135068
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0079828
GHI
—
01
—
0795550
CIGNA
—
01
—
2C4798
HEALTHNET
—
01
—
93A791
BLUE CROSS
—
01
—
WS965
OXFORD
—
Enumeration date
12/19/2006
Last updated
06/28/2010
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