Most Relevant Information
Provider Data
| NPI Number: | 1003528050 |
| Provider Name: | KRISSA MATARLO-SMITH APN |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | 26NJ01407500 |
Most Important Dates
| Enumeration Date: | 12/21/2022 |
| Last Updated: | 12/21/2022 |
Provider Practice Location
65 JAMES ST
EDISON
NJ
088203947
Practice Location Phone/Fax
| Phone: | 7323217733 |
| Fax: |
Provider Mailing Location
37 8TH ST
RIDGEFIELD PARK
NJ
076601005
Provider Mailing Phone/Fax
| Phone: | 2014106108 |
| Fax: |