Individual
MAUREEN MATENGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4949 LIBERTY LN, SUITE 210, ALLENTOWN, PA 18106-9014
(484) 560-6600
Mailing address
4949 LIBERTY LN, SUITE 210, ALLENTOWN, PA 18106-9014
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
TLRN049525
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102888687
—
PA
Enumeration date
03/21/2017
Last updated
03/21/2017
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