Provider Demographics
NPI:1548559644
Name:DIMATTEO, ADRIANA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANA
Middle Name:
Last Name:DIMATTEO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 8TH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:292 SAINT JOHNS PL
Practice Address - Street 2:#52
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-5657
Practice Address - Country:US
Practice Address - Phone:347-350-6067
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-30
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019019103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical