Individual provider Active NPI

Robert Mattera, RPH

  • Pharmacist
  • Brooklyn, NY
National Provider Identifier
1275858136
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
037178 Issued in NY
Practice address
710 Metropolitan Ave
Brooklyn, NY 11211-6714
Phone
(718) 387-0124
Fax
(718) 387-0946
NPI assigned
Apr 5, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 037178 NY Primary

Addresses

Primary practice location

710 Metropolitan Ave
Brooklyn, NY 11211-6714

Mailing address

335 Graham Avenue
Brooklyn, NY 11211

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
037178NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Graham RX Corp CurrentSince Apr 13, 2025 Accepting new patients

Locations

335 Graham Ave
Brooklyn, NY 11211
Phone (718) 246-4100

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744243200000",
    "number": "1275858136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 GRAHAM AVENUE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 METROPOLITAN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112116714",
            "telephone_number": "718-387-0124",
            "fax_number": "718-387-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTERA",
        "first_name": "ROBERT",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-04-05",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "037178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2025; 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.