Matta, Isaac I

Matta, Isaac I is an individual health care provider with primary practice located at 30 Harrison St Ste 400, Johnson City NY 13790. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Otolaryngology, Allopathic & Osteopathic Physicians / Facial Plastic Surgery. Allopathic & Osteopathic Physicians / Facial Plastic Surgery is his primary health care specialty. Matta, Isaac I can be contacted via phone (607) 763-8102.

Contact Information

Primary practice address
30 Harrison St Ste 400 Johnson City NY 13790
Phone: (607) 763-8102
Fax: (607) 770-7375
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 111035 New York
Allopathic & Osteopathic Physicians / Facial Plastic Surgery 207YS0123X 111035 New York

Profile Details

NPI number 1730157686
LBN Legal business name Matta, Isaac I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2006
Last updated May 29th, 2012 - about 12 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 1730157686 NPPES
New York MEDICAID 00365233

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