Miguel Mateo

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

NJDCATEMP Issued in NJ

Practice address

687 Frelinghuysen Ave
Newark, NJ 07114-1349

Phone

(973) 799-0508

NPI assigned

Apr 22, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1587513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587513600000",
    "number": "1366062101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2013 PRINCESS CT # 2013",
            "city": "WOODBRIDGE",
            "state": "NJ",
            "postal_code": "070953800",
            "telephone_number": "908-380-7065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "687 FRELINGHUYSEN AVE",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071141349",
            "telephone_number": "973-799-0508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATEO",
        "first_name": "MIGUEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-04-22",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "NJ",
            "license": "NJDCATEMP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Massak
• Kevin Masse
• Aditi Kalpesh Master, MD
• Aisha Masud
• Daniel Michael Matassa, M.D.
• Mater Dei Behavioral Consult LLC
• Thomas W Materna, M.D.
• Jeevan M Mathew, DPT
• Manju Joseph Mathew, RPH
• Maria Mathew, MD

• Addiction (Substance Use Disorder) Psychologist in Newark, NJ
• Providers in Newark, NJ by specialty
• Addiction (Substance Use Disorder) Psychologist in New Jersey

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