Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2251N0400X | Physical Therapist - Neurology | 019367-1 | NY |
Y | 2251P0200X | Physical Therapist - Pediatrics | 019367-1 | NY |
N | 2251X0800X | Physical Therapist - Orthopedic | 019367-1 | NY |
NPI | 1538466487 |
---|---|
Provider Name | Mr. Matthew Battinelli |
First Address | Staten Island, NY 10314-2366 |
Second Address | Staten Island, NY 10308-3030 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/02/2011 |
Last Update Date | 11/02/2011 |