Provider Demographics
NPI:1952686974
Name:HELEN MATESIC
Entity Type:Organization
Organization Name:HELEN MATESIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED NURSE
Authorized Official - Prefix:
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:S
Authorized Official - Last Name:MATESIC
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:845-298-9205
Mailing Address - Street 1:106 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:FISHKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12524-1144
Mailing Address - Country:US
Mailing Address - Phone:845-896-4389
Mailing Address - Fax:845-896-8477
Practice Address - Street 1:106 JACKSON ST
Practice Address - Street 2:
Practice Address - City:FISHKILL
Practice Address - State:NY
Practice Address - Zip Code:12524-1144
Practice Address - Country:US
Practice Address - Phone:845-896-4389
Practice Address - Fax:845-896-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-21
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3603561261QS1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health