Provider Demographics
NPI:1427780766
Name:MATETIC, MORGAN TAYLOR
Entity type:Individual
Prefix:DR
First Name:MORGAN
Middle Name:TAYLOR
Last Name:MATETIC
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3000 PERIMETER BLVD APT 330
Mailing Address - Street 2:
Mailing Address - City:SOUTH PARK
Mailing Address - State:PA
Mailing Address - Zip Code:15129-5527
Mailing Address - Country:US
Mailing Address - Phone:724-986-1284
Mailing Address - Fax:
Practice Address - Street 1:2639 BROWNSVILLE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15227-2005
Practice Address - Country:US
Practice Address - Phone:412-881-4242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG003895152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist