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1174921951
JACQUELINE DIANE MATIAS
MELVILLE, NY
NPI
1174921951
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
Enumeration Date
2014-12-10
Last Update Date
2014-12-10
Business Address
Mrs. JACQUELINE DIANE MATIAS
538 BROADHOLLOW RD STE 202
MELVILLE, NY 11747-3668
Phone number: 631-385-7780
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Mailing Address
Mrs. JACQUELINE DIANE MATIAS
15 SOUNDVIEW DR
SHOREHAM, NY 11786-1101
Phone number: 631-849-1664
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