Mataybo Medical PLLC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

Legal business name

MATAYBO MEDICAL PLLC

Practice address

1236 Fulton St
Brooklyn, NY 11216-2093

Phone

(718) 230-4200

Fax

(718) 230-4277

NPI assigned

May 26, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Terry Blackett-Bonnett, M.D.

Title

Administrative Partner

Phone

(718) 230-4200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1211760000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211760000000",
    "number": "1730347923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1236 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162093",
            "telephone_number": "718-230-4200",
            "fax_number": "718-230-4277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1236 FULTON ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162093",
            "telephone_number": "718-230-4200",
            "fax_number": "718-230-4277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MATAYBO MEDICAL PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-26",
        "last_updated": "2008-05-26",
        "status": "A",
        "authorized_official_last_name": "BLACKETT-BONNETT",
        "authorized_official_first_name": "TERRY",
        "authorized_official_title_or_position": "ADMINISTRATIVE PARTNER",
        "authorized_official_telephone_number": "718-230-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rafail B Matatov, RPH
• Valeriy A Matatov, M.D.
• Irina Matatova, FNP
• Roza Matatova
• Yelena Matatova
• Gulya Matayeva
• Mira Matayeva, PHARM.D.
• Maia Matcharashvili
• Neil Robert Mate, D.D.S.
• Wardah Mateen, RPH

• Pediatrics Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Pediatrics Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2008; 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.