Provider Demographics
NPI:1235823378
Name:MATONEY, ROBERT JACOB III
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JACOB
Last Name:MATONEY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:MATONEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2565 12TH ST APT A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3739
Mailing Address - Country:US
Mailing Address - Phone:917-992-6487
Mailing Address - Fax:
Practice Address - Street 1:307 W 38TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018-2913
Practice Address - Country:US
Practice Address - Phone:212-367-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health