Provider Demographics
NPI:1336674092
Name:LAWNEY, MATTHEW HENRY (PT)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:HENRY
Last Name:LAWNEY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 54
Mailing Address - Street 2:
Mailing Address - City:FORT MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:10922-0054
Mailing Address - Country:US
Mailing Address - Phone:845-642-6461
Mailing Address - Fax:845-335-5631
Practice Address - Street 1:1070 ROUTE 9W
Practice Address - Street 2:
Practice Address - City:FORT MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:10922
Practice Address - Country:US
Practice Address - Phone:845-642-6461
Practice Address - Fax:845-335-5631
Is Sole Proprietor?:No
Enumeration Date:2017-05-01
Last Update Date:2017-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020128225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist