| Isaac I Matta, MD | |
|
30 Harrison St, Ste 400, Johnson City, NY 13790 | |
| (607) 763-8102 | |
| (607) 770-7375 |
| Full Name | Isaac I Matta |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology - Facial Plastic Surgery |
| Location | 30 Harrison St, Johnson City, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730157686 | NPI | - | NPPES |
| 00365233 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 111035 (New York) | Secondary |
| 207YS0123X | Otolaryngology - Facial Plastic Surgery | 111035 (New York) | Primary |
| Entity Name | United Health Services Hospitals, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1962463851 PECOS PAC ID: 5193610533 Enrollment ID: O20040216001017 |
| Mailing Address | Practice Location Address |
|---|---|
| Isaac I Matta, MD 346 Grand Ave, Johnson City, NY 13790-2580 Ph: (607) 729-8156 | Isaac I Matta, MD 30 Harrison St, Ste 400, Johnson City, NY 13790 Ph: (607) 763-8102 |
James Eng, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 30 Harrison St Ste 355, Johnson City, NY 13790 Phone: 607-763-8102 | |
Dr. Mahmoud Issam Awad, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 30 Harrison St Ste 350, Johnson City, NY 13790 Phone: 607-763-8102 Fax: 607-763-8018 | |
Dr. Jeffrey M King, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 15 Riverside Dr, Johnson City, NY 13790 Phone: 607-770-9050 Fax: 607-770-9091 |