Provider Demographics
NPI:1952459554
Name:MATRO, DEBORAH B (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:B
Last Name:MATRO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:
Other - Last Name:BRANDCHAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:4 BRADSON CT
Mailing Address - Street 2:
Mailing Address - City:WESTFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07090-1962
Mailing Address - Country:US
Mailing Address - Phone:732-494-5207
Mailing Address - Fax:908-654-1954
Practice Address - Street 1:4 BRADSON CT
Practice Address - Street 2:
Practice Address - City:WESTFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07090-1962
Practice Address - Country:US
Practice Address - Phone:732-494-5207
Practice Address - Fax:908-654-1954
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2010-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMAO331292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ457591Medicare UPIN