MARQUE-ANN MATTLE PA NPI 1588724132

NPI Information

NPI: 1588724132
Provider Name: MARQUE-ANN MATTLE, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
135 CORPORATE WOODS STE 200
ROCHESTER, NY
ZIP 14623
Phone: (585) 784-7848
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Marque-ann Mattle, PA is a medical physician assistant in Rochester, NY with 18 years of experience. Marque-ann Mattle, PA NPI is 1588724132. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: YALE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2006

The provider's business location address is:

135 CORPORATE WOODS STE 200
ROCHESTER, NY
ZIP 14623-459
Phone: (585) 784-7848

The NPI 1588724132 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 12/12/2006 and was last updated on 7/21/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	11668	NEW YORK	No
2	363AM0700X	Physician Assistant	Medical	011668	NEW YORK	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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