Organization Active NPI

Marina Matatova DO PC

  • Dermatology Physician
  • Brooklyn, NY
National Provider Identifier
1578148185
Registry record updated Mar 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
MARINA MATATOVA DO PC
Practice address
391 Stanhope St
Brooklyn, NY 11237-4404
Phone
(718) 366-1747
Fax
(718) 606-8966
NPI assigned
Mar 15, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2021

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

Authorized official

Name
Wendy Sanchez
Title
Office Manager
Phone
(347) 642-9802

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

391 Stanhope St
Brooklyn, NY 11237-4404

Mailing address

4037 74TH St
Elmhurst, NY 11373-5603
Phone (718) 651-7000

National Provider Directory

National Provider Directory

Locations

4037 74th St
Flushing, NY 11373
Phone (347) 642-9802

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1615766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615766400000",
    "number": "1578148185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4037 74TH ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113735603",
            "telephone_number": "718-651-7000",
            "fax_number": "718-606-8966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 STANHOPE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112374404",
            "telephone_number": "718-366-1747",
            "fax_number": "718-606-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARINA MATATOVA DO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-15",
        "last_updated": "2021-03-15",
        "certification_date": "2021-03-15",
        "status": "A",
        "authorized_official_last_name": "SANCHEZ",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "347-642-9802"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "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 Mar 15, 2021; 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.