Mrs. Lori S. Matulewicz
Nurse Practitioner (Psychiatric/Mental Health)

Address: 500 Central Ave., Equinox, Inc., Albany, NY 12206
Phone: 5184359931

Mrs. Lori S. Matulewicz (NPI# 1679993828) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider Identifier (NPI) 1679993828
Entity Type Individual
Full Name Mrs. Lori S. Matulewicz
Credential N.P.P.
Gender Female
Practice Address 500 Central Ave.
Equinox, Inc.
Albany
NY 12206
Practice Telephone 5184359931
Practice Fax Number 5184359937
Mailing Address 500 Central Ave
Equinox, Inc.
Albany
NY 12206
Sole Proprietor No, this individual is not a Sole Proprietor
Enumeration Date 2014-04-25
Last Update Date 2018-03-02

Taxonomy Codes

Primary Taxonomy Classification Taxonomy Group License Number State
Yes 363LP0808X Nurse Practitioner · Psychiatric/Mental Health Physician Assistants & Advanced Practice Nursing Providers F-401682 NY
No 363LP0808X Nurse Practitioner · Psychiatric/Mental Health Physician Assistants & Advanced Practice Nursing Providers F401682-1 NY

Physician Overview

NPI 1679993828
PAC ID by PECOS 4486872629
Professional Enrollment ID I20140829000320
Full Name Lori S Matulewicz
Organization Legal Name EQUINOX INC.
Phone Number 5184359931
Gender F
Graduation Year 2013
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 7416946538
Number of Group Practice Members 8
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
330057 ST PETER'S HOSPITAL

Office Location

Street Address 500 CENTRAL AVE.
EQUINOX, INC.
City ALBANY
State NY
Zip Code 12206

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942713144 Jaclyn Nanna Physical Therapist 1367 Washington Ave Ste 100, Albany, NY 12206 2017-11-09
1144749854 Madena Lynn Henderson Licensed Practical Nurse 51 Garfield Pl, Albany, NY 12206 2017-09-13
1912456534 Adeel A Janjua I Contractor 17 Roosevelt St, Albany, NY 12206 2016-09-23
1376901595 Jacqueline Aimee Dall Nurse Practitioner 855 Central Avenue, Albany, NY 12206 2016-02-02
1376932558 Hope House, Inc. Substance Abuse Rehabilitation Facility 577 Livingston Ave., Albany, NY 12206 2015-01-12
1437417995 Ernest Nicola Chisena Orthopaedic Surgery 1367 Washington Avenue Suite 200, Albany, NY 12206 2012-05-02
1629368519 Joseph M Rozell Radiology 255 Patroon Creek Blvd Apt 3439, Albany, NY 12206 2011-04-12
1346542404 Melissa June Kowlessar Licensed Practical Nurse 69 Benson Street, Albany, NY 12206 2010-11-23
1316109796 Edmund John Mcgrath Podiatrist 911 Central Avenue #24, Albany, NY 12206 2008-06-27
1861676009 Capital District Pediatrics P.l.l.c Clinic/Center 400 Patroon Creek, Suite 201, Albany, NY 12206 2007-12-24
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Taxonomy Information

Taxonomy Code 363LP0808X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Psychiatric/Mental Health

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1285133603 Patricia Hayden Schiller Nurse Practitioner 16 Computer Dr W Ste 103, Albany, NY 12205-1624 2018-02-12
1366847246 Sage College Wellness Center - Albany Nurse Practitioner 140 Nw Scotland Ave, Albany, NY 12208 2014-11-04
1598918161 Maureen Mary Masterson Nurse Practitioner 75 New Scotland Avenue, Capital District Psychiatric Center, Albany, NY 12208-3409 2008-10-28
1760539357 Penny Lee Stute Nurse Practitioner 3311 Madison St Se, Albany, OR 97322-4151 2007-01-04
1801961669 Marilyn Anne Vondollen Nurse Practitioner 1471 Western Ave, Albany, NY 12203-3512 2006-11-21
1124117403 Melissa S Goodemote Nurse Practitioner 423a New Karner Rd., Upper Level, Albany, NY 12205-1840 2006-10-12
1780631341 Lisa Zawalski Nurse Practitioner 1 Pinnacle Place Suite 102, Pinnacle Behavioral Health, Albany, NY 12203-3001 2006-05-28
1366912537 Taylor Gamble Nurse Practitioner 601 11th Ave, Albany, GA 31701-1645 2018-11-30
1801381728 Tanya Parent Nurse Practitioner 314 S Manning Blvd, Albany, NY 12208-1794 2018-06-22
1215458641 Carole A Rumberger Nurse Practitioner 25 Hackett Blvd, Floor 2, Albany, NY 12208 2017-07-07
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Competitor

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City ALBANY
Zip Code 12206

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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