Provider Demographics
NPI:1346804028
Name:NITTI, MATT
Entity Type:Individual
Prefix:
First Name:MATT
Middle Name:
Last Name:NITTI
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 1:1500 CHESTNUT ST APT 9C
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-2744
Mailing Address - Country:US
Mailing Address - Phone:551-427-1937
Mailing Address - Fax:
Practice Address - Street 1:1500 CHESTNUT ST APT 9C
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102-2744
Practice Address - Country:US
Practice Address - Phone:551-427-1937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-27
Last Update Date:2019-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program