Jodianne Materasso, MSed
Specialist in Pelham, NY. Individual provider (NPI-1).
NPI number1053674580
StatusActive
Last updated in NPPESJun 19, 2012
Details
- NPI
- 1053674580
- Entity type
- Individual (NPI-1)
- Name
- Jodianne Materasso
- Credential
- MSed
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 19, 2012
- Last updated
- Jun 19, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 457081101 | NY | Yes |
| 174400000X | Specialist | 457080101 | NY |
Practice location
39 6th StPelham, NY 10803-1140
Phone 914-755-6373
Mailing address
39 6th StPelham, NY 10803-1140
Phone 914-755-6373
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 7 Specialist providers in Pelham · All 263 providers in Pelham
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