Active NPI
Mitchell Bryan Matza, RPH
- Pharmacist
- Long Beach, NY
National Provider Identifier
1831411578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- I037466
- Practice address
- 23 E Park Ave
Long Beach, NY 11561-3597 - Phone
- (516) 431-4422
- NPI assigned
- Feb 23, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS 22902 | FL | |
| Pharmacist | 183500000X | I037466 | NY | Primary |
Addresses
Primary practice location
23 E Park Ave
Long Beach, NY 11561-3597
Mailing address
PO Box 93
East Rockaway, NY 11518-0093
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
| License | State | Type | Specialty |
|---|---|---|---|
| PS 22902 | FL | MD | Pharmacist |
| I037466 | NY | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1266883200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1351036800000",
"number": "1831411578",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 93",
"city": "EAST ROCKAWAY",
"state": "NY",
"postal_code": "115180093"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "23 E PARK AVE",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115613597",
"telephone_number": "516-431-4422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATZA",
"first_name": "MITCHELL",
"middle_name": "BRYAN",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-02-23",
"last_updated": "2012-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS 22902",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NY",
"license": "I037466",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Long Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.