Provider Demographics
NPI:1508967506
Name:MATA, ZENAIDA M (MD)
Entity Type:Individual
Prefix:
First Name:ZENAIDA
Middle Name:M
Last Name:MATA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:67 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13905
Mailing Address - Country:US
Mailing Address - Phone:607-723-4932
Mailing Address - Fax:607-771-4824
Practice Address - Street 1:67 MAIN ST
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905
Practice Address - Country:US
Practice Address - Phone:607-723-4932
Practice Address - Fax:607-771-4824
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY145690171100000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry