Provider Demographics
NPI:1457661522
Name:MATTEN, MARCIA H (RN MSN)
Entity Type:Individual
Prefix:MRS
First Name:MARCIA
Middle Name:H
Last Name:MATTEN
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2629 LORETTA ST
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-2925
Mailing Address - Country:US
Mailing Address - Phone:914-245-7671
Mailing Address - Fax:
Practice Address - Street 1:2629 LORETTA ST
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-2925
Practice Address - Country:US
Practice Address - Phone:914-245-7671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-07
Last Update Date:2010-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY313097-1163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health