| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JONAH MICAH MATEOS | 1740884618 | 2020-11-22 |
Jonah Micah Mateos is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1740884618. Registration indicates Jonah Micah Mateos is a provider of services with a specialization in Nursing Service Providers, Registered Nurse (Registered Nurse: Dialysis, Peritoneal, ) (Registered Nurse Dialysis, Peritoneal, Nursing Service Providers) (Registered Nurse, )
| Entity Type | Individual |
| Provider Name | Jonah Micah Mateos |
| Practice Office Address | 1150 RIVER RD APT 2C EDGEWATER, NJ US |
| Practice Office Telephone | 2023751890 |
| Mailing Address | 1150 RIVER RD APT 2C EDGEWATER, NJ 070201347 US |
| Business Telephone | 2023751890 |
| Code | Practice | License No State |
|---|---|---|
| 163WD1100X PRIMARY | Nursing Service Providers Registered Nurse Registered Nurse: Dialysis, Peritoneal Registered Nurse Dialysis, Peritoneal Nursing Service Providers Registered Nurse | 787603-01
NY |