Provider Demographics
NPI:1831347426
Name:MATOSSIAN, DEBORA (MD)
Entity type:Individual
Prefix:MISS
First Name:DEBORA
Middle Name:
Last Name:MATOSSIAN
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1 MEDICAL CENTER DR
Mailing Address - Street 2:DHMC - DEPT OF PEDIATRIC NEPHROLOGY
Mailing Address - City:LEBANON
Mailing Address - State:NH
Mailing Address - Zip Code:03756-1000
Mailing Address - Country:US
Mailing Address - Phone:603-653-9884
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DR
Practice Address - Street 2:DHMC - DEPT OF PEDIATRIC NEPHROLOGY
Practice Address - City:LEBANON
Practice Address - State:NH
Practice Address - Zip Code:03756-1000
Practice Address - Country:US
Practice Address - Phone:603-653-9884
Practice Address - Fax:603-650-0907
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH156702080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology