Provider Demographics
NPI:1275927139
Name:MATTERN, AMY (DO)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:
Last Name:MATTERN
Suffix:
Gender:
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:109 W 27TH ST RM 5S
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-6208
Mailing Address - Country:US
Mailing Address - Phone:833-351-8255
Mailing Address - Fax:888-815-3583
Practice Address - Street 1:1 W WINTER ST STE 200
Practice Address - Street 2:
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-4635
Practice Address - Country:US
Practice Address - Phone:513-828-0285
Practice Address - Fax:888-815-3583
Is Sole Proprietor?:No
Enumeration Date:2015-03-27
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3196862084P0800X
OH34.0136452084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry