Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OC008193 | PA |
NPI | 1003034612 |
---|---|
Provider Name | Matthew C Durny |
First Address | Cherry Hill, NJ 08003-1000 |
Second Address | Cherry Hill, NJ 08003-1000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2007 |
Last Update Date | 05/03/2013 |