Provider Demographics
NPI:1306194063
Name:MATIKA, BEATRICE JOEL
Entity Type:Individual
Prefix:
First Name:BEATRICE
Middle Name:JOEL
Last Name:MATIKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18225 LOST KNIFE CIR APT 102
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY VILLAGE
Mailing Address - State:MD
Mailing Address - Zip Code:20886-4222
Mailing Address - Country:US
Mailing Address - Phone:202-529-6510
Mailing Address - Fax:
Practice Address - Street 1:18225 LOST KNIFE CIR APT 102
Practice Address - Street 2:
Practice Address - City:MONTGOMERY VILLAGE
Practice Address - State:MD
Practice Address - Zip Code:20886-4222
Practice Address - Country:US
Practice Address - Phone:202-529-6510
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide