Materia, Dana

Materia, Dana is an individual health care provider with primary practice located at 1147 Richmond Rd , Staten Island NY 10304-2423. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Materia, Dana can be contacted via phone (718) 816-9056.

Contact Information

Primary practice address
1147 Richmond Rd Staten Island NY 10304-2423
Phone: (718) 816-9056
Fax: (718) 816-1165
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X F334092 New York

Profile Details

NPI number 1740263839
LBN Legal business name Materia, Dana
Credentials ANCC
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 22nd, 2005
Last updated May 13th, 2010 - about 15 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 1740263839 NPPES
New York MEDICAID 02427301

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