Provider Demographics
NPI:1023379203
Name:WERT, MATTHEW ALAN (MD)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:ALAN
Last Name:WERT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:263 7TH AVE
Mailing Address - Street 2:SUITE 2B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-7247
Mailing Address - Country:US
Mailing Address - Phone:718-246-8700
Mailing Address - Fax:718-332-0414
Practice Address - Street 1:263 7TH AVE
Practice Address - Street 2:SUITE 2B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-7247
Practice Address - Country:US
Practice Address - Phone:718-246-8700
Practice Address - Fax:718-332-0414
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-04
Last Update Date:2017-01-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MS21976207X00000X
NY268312-1207XX0005X, 207X00000X
NJ25MA09281400207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery