Provider Demographics
NPI:1073820791
Name:PYNE, MATTHEW MARCUS
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:MARCUS
Last Name:PYNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 ADAMS ST
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02351-1359
Mailing Address - Country:US
Mailing Address - Phone:203-910-8577
Mailing Address - Fax:
Practice Address - Street 1:406 ADAMS ST
Practice Address - Street 2:
Practice Address - City:ABINGTON
Practice Address - State:MA
Practice Address - Zip Code:02351-1359
Practice Address - Country:US
Practice Address - Phone:203-910-8577
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA119610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health