Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD065116L | PA |
N | 208600000X | Surgeon | MD065116L | PA |
Y | 2086S0120X | Pediatric Surgery | MD065116L | PA |
NPI | 1356430920 |
---|---|
Provider Name | Dr. Peter A Mattei |
First Address | Philadelphia, PA 19107-3323 |
Second Address | Philadelphia, PA 19104 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 11/04/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001708807 | (05) | PA |
F39174 | (02) | PA |