Provider Demographics
NPI:1558950444
Name:MATONE, MARY (RD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:
Last Name:MATONE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 MONROE ST STE E518
Mailing Address - Street 2:
Mailing Address - City:HOBOKEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07030-6375
Mailing Address - Country:US
Mailing Address - Phone:908-268-1283
Mailing Address - Fax:
Practice Address - Street 1:720 MONROE ST STE E518
Practice Address - Street 2:
Practice Address - City:HOBOKEN
Practice Address - State:NJ
Practice Address - Zip Code:07030-6375
Practice Address - Country:US
Practice Address - Phone:908-268-1283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-14
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered