Provider Demographics
NPI:1083693089
Name:MATARESE, EMIL L (MD)
Entity Type:Individual
Prefix:DR
First Name:EMIL
Middle Name:L
Last Name:MATARESE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:680 MIDDLETOWN BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1817
Mailing Address - Country:US
Mailing Address - Phone:215-741-9555
Mailing Address - Fax:215-741-6075
Practice Address - Street 1:680 MIDDLETOWN BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1817
Practice Address - Country:US
Practice Address - Phone:215-741-9555
Practice Address - Fax:215-741-6075
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2021-04-26
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Provider Licenses
StateLicense IDTaxonomies
PAMD036537-E2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA47300OtherKEYSTONE MERCY HEALTH PLA
PACH0208OtherRAILROAD MEDICARE
PA09159OtherHEALTH PARTNERS
PA0439846000OtherINDEPENDENCE BLUE CROSS
PA118039000OtherUS WORKERS COMP
PA611728OtherPA BLUE SHIELD
PA118039000OtherUS WORKERS COMP
PA133057JXQMedicare PIN