Lori M. Matczak, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN261173L Issued in PA

Practice address

3975 Conshohocken Ave
Philadelphia, PA 19131-5426

Phone

(215) 879-1000

Fax

(215) 879-3912

NPI assigned

May 3, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1497977151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "843 RISING SUN RD",
            "city": "TELFORD",
            "state": "PA",
            "postal_code": "189692125",
            "telephone_number": "215-368-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3975 CONSHOHOCKEN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191315426",
            "telephone_number": "215-879-1000",
            "fax_number": "215-879-3912"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATCZAK",
        "first_name": "LORI",
        "middle_name": "M.",
        "name_prefix": "Ms.",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "PA",
            "license": "RN261173L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0019272130004",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Terence Matalon, M.D.
• Wadih Youssef Matar, MSC, MD, FRCSC
• Francis S Matarazzo, D.D.S.
• Stephanie Ashritha Matcha, DPM
• Ewa G Matczak, DMD
• Marco J Matejka, CRNA
• Madison Nicole Matello, PA-C
• Jose Manuel Mateo-Bermudez, M.D.
• Alina M Mateo, M.D.
• Sara Mateo, MD

• Registered Nurse in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Registered Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.