Provider Demographics
NPI:1376647784
Name:TADDEO, MATILDA MARY (MD)
Entity Type:Individual
Prefix:DR
First Name:MATILDA
Middle Name:MARY
Last Name:TADDEO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1 PONDFIELD RD W
Mailing Address - Street 2:
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-2666
Mailing Address - Country:US
Mailing Address - Phone:914-793-1606
Mailing Address - Fax:914-793-1837
Practice Address - Street 1:1 PONDFIELD RD W
Practice Address - Street 2:
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-2666
Practice Address - Country:US
Practice Address - Phone:914-793-1606
Practice Address - Fax:914-793-1837
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NY168065207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYE75467Medicare UPIN