Basic Information
| Provider Information | |||||||||
| NPI: | 1013002104 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHEBES | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | L. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | RPA-C, MHA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4 TULIPWOOD DR | ||||||||
| Address2: | |||||||||
| City: | COMMACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 117255616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6315436112 | ||||||||
| FaxNumber: | 7183433429 | ||||||||
| Practice Location | |||||||||
| Address1: | LONG ISLAND JEWISH MEDICAL CENTER-DEPARTMENT OF SURGERY | ||||||||
| Address2: | 270-05, 76 AVE | ||||||||
| City: | NEW HYDE PARK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 11042 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7184707210 | ||||||||
| FaxNumber: | 7183433429 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AS0400X | 002441 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
No ID Information.