Provider Demographics
NPI:1265418099
Name:MATTEONI, CHRISTI (MD)
Entity type:Individual
Prefix:
First Name:CHRISTI
Middle Name:
Last Name:MATTEONI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 MILL ST # MS 14
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89502-1576
Mailing Address - Country:US
Mailing Address - Phone:779-982-5262
Mailing Address - Fax:775-982-5496
Practice Address - Street 1:1155 MILL ST # MS 14
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89502-1576
Practice Address - Country:US
Practice Address - Phone:779-982-5262
Practice Address - Fax:775-982-5496
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV9049207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV2016730Medicaid
NVV32012Medicare PIN
NVH02647Medicare UPIN