Robert E Dematteo MD PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

173247 Issued in NY

Legal business name

ROBERT E DEMATTEO MD PLLC

Practice address

970 N Broadway
Suite 209
Yonkers, NY 10701-1309

Phone

(914) 965-3366

Fax

(914) 965-1310

NPI assigned

Mar 22, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Enrico Dematteo, MD

Title

Sole Proprietor

Phone

(914) 965-3366

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1235255142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 NORTH BROADWAY",
            "address_2": "SUITE 209",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011311",
            "telephone_number": "914-965-3366",
            "fax_number": "914-965-1310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 N BROADWAY",
            "address_2": "SUITE 209",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107011309",
            "telephone_number": "914-965-3366",
            "fax_number": "914-965-1310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT E DEMATTEO MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DEMATTEO",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ENRICO",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "914-965-3366",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "NY",
            "license": "173247",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01066435",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Yonkers, NY
• Providers in Yonkers, NY by specialty
• Specialist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.