HEIDI MATISOFF NP NPI 1609267376

NPI Information

  • NPI: 1609267376
  • Provider Name: HEIDI MATISOFF, NP
  • Classification: Nurse Practitioner - 363LP2300X
  • Specialization: Primary Care
  • Entity Type: Individual
  • Address: 4781 BROADWAY
    NEW YORK, NY
    ZIP 10034
  • Phone: (212) 304-6920

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NPI Details

Heidi Matisoff, NP is a primary care nurse practitioner in New York, NY. Heidi Matisoff, NP NPI is 1609267376. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4781 BROADWAY
NEW YORK, NY
ZIP 10034-915
Phone: (212) 304-6920
Fax: (212) 544-5849

The enumeration date for this NPI number is 2/16/2015 and was last updated on 3/3/2016.

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
1363LP2300XNurse PractitionerPrimary CareF306939-1NEW YORKYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
104093050MEDICAIDNEW YORK

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: 3/30/2025

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