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Dr. Roman W Matlaga

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NPI Number Detailed Information

Provider Information:

Name: Dr. Roman W Matlaga
Gender: M
Provider License Number If Given: OS008779L

NPI Information:

NPI: 1881688315
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 12/21/2010

Provider Business Mailing Address:

Address: 15 BODINE LN
Honesdale, PA 18431
Phone Number: 5702539164
Fax Number:

Provider Business Practice Location Address:

Address: 103 SPRUCE ST
Hawley, PA 18428
Phone Number: 5703904545
Fax Number: 5703904546

Provider Taxonomy:

Primary: 207P00000X
Secondary (if any): 207R00000X
State: PA

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