| Javier M. Matos | |
|
60-14 60th Street Suite B Maspeth NY 11378-3410 | |
| (718) 366-6252 | |
| (718) 366-6253 |
| Full Name | Javier M. Matos |
|---|---|
| Speciality | Social Worker |
| Location | 60-14 60th Street, Maspeth, New York |
| Authorized Official Name and Position | Javier Milton Matos (PRESIDENT) |
| Authorized Official Contact | 7183666252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Javier M. Matos 60-14 60th Street Suite B Maspeth NY 11378-3410 Ph: (718) 366-6252 | Javier M. Matos 60-14 60th Street Suite B Maspeth NY 11378-3410 Ph: (718) 366-6252 |
| NPI Number | 1821200999 |
|---|---|
| Provider Enumeration Date | 05/03/2007 |
| Last Update Date | 11/29/2016 |
| Medicare PECOS PAC ID | 3173889045 |
|---|---|
| Medicare Enrollment ID | O20171108003284 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821200999 | NPI | - | NPPES |
| 02209263 | Medicaid | NY | |
| 1275559965 | Other | NY | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 069411 (New York) | Primary |
| Provider Name | Javier M Matos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1275559965 PECOS PAC ID: 6507123700 Enrollment ID: I20171127000352 |
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