Provider Demographics
NPI:1003365925
Name:CUMELLA, MATTHEW T (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:T
Last Name:CUMELLA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 HARVEST CIR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:MA
Mailing Address - Zip Code:01773-3213
Mailing Address - Country:US
Mailing Address - Phone:781-430-6719
Mailing Address - Fax:978-313-6024
Practice Address - Street 1:3 HARVEST CIR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:MA
Practice Address - Zip Code:01773-3213
Practice Address - Country:US
Practice Address - Phone:781-430-6719
Practice Address - Fax:978-313-6024
Is Sole Proprietor?:No
Enumeration Date:2016-10-04
Last Update Date:2016-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA21215225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist