Matayev, Raisa

Matayev, Raisa is an individual health care provider with primary practice located at 176-60 Union Turnpike Suite 360, Fresh Meadows NY 11366. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Matayev, Raisa can be contacted via phone (718) 460-2300.

Contact Information

Primary practice address
176-60 Union Turnpike Suite 360 Fresh Meadows NY 11366
Phone: (718) 460-2300
Fax: (718) 460-9697
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 010414 New York

Profile Details

NPI number 1134211873
LBN Legal business name Matayev, Raisa
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 29th, 2006
Last updated Aug 4th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134211873 NPPES
New York MEDICAID 00246075

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