DR. YESU MATTA (NPI# 1851648471) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851648471 |
| Entity Type | Individual |
| Full Name | DR. YESU MATTA |
| Credential | M.D. |
| Practice Address |
675 Main Street Middletown CT 06457-0645 |
| Mailing Address |
506 Lenox Ave # Mlk17110 New York NY 10037-1802 |
| Practice Telephone | 8603476971 |
| Mailing Telephone | 2129394019 |
| Mailing Fax Number | 2129394022 |
| Enumeration Date | 2012-08-14 |
| Last Update Date | 2020-01-22 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 64545 | CT | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 506 Lenox Ave # Mlk17110, New York, NY 100371802 | 2129394019 | 2129394022 |
| Street Address |
675 MAIN STREET |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-0645 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477752525 | Stephanie Noto | Counselor | 675 Main Street, Middletown, CT 06457 | 2007-07-17 |
| 1215537980 | Chelsea Schnorrbusch | Student in an Organized Health Care Education/Training Program | 675 Main Street, Middletown, CT 06457 | 2020-10-30 |
| 1538767165 | Allegra Velazquez | Nutritionist | 675 Main Street, Middletown, CT 06457-2632 | 2020-10-15 |
| 1659998581 | Vanessa Latson | Registered Nurse | 675 Main Street, Middletown, CT 06457 | 2020-06-26 |
| 1528680683 | Sarah Barnhart | Registered Nurse | 675 Main Street, Middletown, CT 06457-2632 | 2020-05-12 |
| 1740801471 | Polly Huynh | Registered Nurse | 675 Main Street, Middletown, CT 06457 | 2020-05-05 |
| 1093342958 | Tanesha Tamara Rankine | Counselor | 675 Main Street, Middletown, CT 06457 | 2020-03-23 |
| 1801422001 | Shawn Curtis | Psychologist | 675 Main Street, Middletown, CT 06457 | 2020-03-19 |
| 1487200226 | Suzanne Mayo Watson | Nurse Practitioner | 675 Main Street, Middletown, CT 06457 | 2019-08-16 |
| 1104479583 | Laina Jean Cross | Nurse Practitioner | 675 Main Street, Middletown, CT 06457 | 2019-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699391961 | Meghan Harrington | Behavior Technician | 101 Centerpoint Drive #243, Middletown, CT 06457 | 2020-06-22 |
| 1427619626 | Collaborative Aba Services, LLC | Behavioral Analyst | 515 Centerpoint Drive, Suite 205, Middletown, CT 06457 | 2019-06-27 |
| 1376100339 | Kimberly Tynik | Pharmacist | 451 Fowler Ave, Middletown, CT 06457 | 2019-05-24 |
| 1184101263 | Tabrez Adil | Dentist | 675 Main St., Middletown, CT 06457 | 2018-07-23 |
| 1326535337 | Rehan Khan | Non-emergency Medical Transport (VAN) | 765 Country Club Rd, Middletown, CT 06457 | 2018-04-16 |
| 1366950206 | State of Connecticut | Psychiatric Hospital | 70 O'brien Drive, Middletown, CT 06457 | 2018-01-12 |
| 1902324536 | Cynthia Tine | Physical Therapy Assistant | 628 Congdon Street, Middletown, CT 06457 | 2017-09-04 |
| 1619494390 | Nathan Douglas Roy | Specialist/Technologist | 431 Briarwood Lane, Middletown, CT 06457 | 2017-08-24 |
| 1598286502 | Rachel Hoffman Whelen | Registered Nurse | 420 Saybrook Road, Suite A, Middletown, CT 06457 | 2017-06-29 |
| 1003358326 | Rebecca Rotondo | Social Worker | 230 Main Street Extension, Act Team, Gilead Community Services, Middletown, CT 06457 | 2016-11-17 |
| Find all providers in zip 06457 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821328162 | Kenneth Mark Robbins | Pediatrics | 10 Yellow Birch Rd, Middletown, CT 06457-4921 | 2010-01-09 |
| 1104066653 | James Y Cho | Pediatrics | 3 Manitto Pl, Middletown, NJ 07748-3707 | 2009-02-24 |
| 1982870077 | Warren Gilman | Pediatrics | 7 Starhaven Ave, Middletown, NY 10940-4617 | 2008-05-07 |
| 1528187572 | Dunning Road Pediatrics | Pediatrics | 390 Crystal Run Road Suite110, Middletown, NY 10941 | 2007-03-29 |
| 1932233293 | David Hill | Pediatrics | 100 Crystal Run Road, Suite 107, Middletown, NY 10940 | 2007-03-16 |
| 1912047861 | Middletown Community Health Center Inc | Pediatrics | 14 Grove Street, Middletown, NY 10940 | 2007-02-08 |
| 1780759050 | Chitra Vaidy | Pediatrics | 200 Cleaver Farm Rd Ste 201, Nemours Dupont Pediatrics, Middletown, Middletown, DE 19709-1630 | 2006-11-22 |
| 1851482236 | Gerard A. Kuhn | Pediatrics | Nemours Pediatrics Middletown, 200 Cleaver Farm Road Suite 201, Middletown, DE 19709-1630 | 2006-09-28 |
| 1801900741 | Diana E Small | Pediatrics | 331 N Breiel Blvd, Middletown, OH 45042 | 2006-08-18 |
| 1992819833 | James Michael Komer | Pediatrics | 331 N Breier Road, Middletown, OH 45042 | 2006-08-18 |
| Find all providers in MIDDLETOWN | ||||
| City | MIDDLETOWN |
| Zip Code | 06457 |
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| 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.