Mary Matyas, APN

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

NN75099 Issued in NJ

Practice address

6106 Black Horse Pike
Egg Harbor Township, NJ 08234-9701

Phone

(609) 645-7779

Fax

(908) 301-5456

NPI assigned

Aug 28, 2008

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 names 1

• Mary Farrell Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1219881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1881842235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 NEW PROVIDENCE RD",
            "city": "MOUNTAINSIDE",
            "state": "NJ",
            "postal_code": "070921409",
            "telephone_number": "908-233-3720",
            "fax_number": "908-301-5456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6106 BLACK HORSE PIKE",
            "city": "EGG HARBOR TOWNSHIP",
            "state": "NJ",
            "postal_code": "082349701",
            "telephone_number": "609-645-7779",
            "fax_number": "908-301-5456"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1505 W. Sherman Ave.",
            "address_purpose": "LOCATION",
            "city": "Vineland",
            "state": "NJ",
            "postal_code": "083606912",
            "country_code": "US",
            "telephone_number": "856-641-8000",
            "fax_number": "856-641-7647",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MATYAS",
        "first_name": "MARY",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-28",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NJ",
            "license": "NN75099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "FARRELL",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Christina Martinez
• Estefani Nayely Martinez
• John Edward Martino III, PT
• Luz Matos, LCSW
• Gary Matusow, DO
• Barbara Lee Maxwell, LCSW
• Joseph Benjamin May, MS
• Paula Mayer, BCABA
• Crystal Sheree Mays, M. ED.
• Kyle E McBride

• Pediatric Nurse Practitioner in Egg Harbor Township, NJ
• Providers in Egg Harbor Township, NJ by specialty
• Pediatric Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.