Provider Demographics
NPI:1376594945
Name:EPSTEIN, MATT JEFFREY (OD)
Entity Type:Individual
Prefix:DR
First Name:MATT
Middle Name:JEFFREY
Last Name:EPSTEIN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 CHRISTIANA RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-3040
Mailing Address - Country:US
Mailing Address - Phone:302-322-4444
Mailing Address - Fax:302-322-0875
Practice Address - Street 1:169 CHRISTIANA RD
Practice Address - Street 2:
Practice Address - City:NEW CASTLE
Practice Address - State:DE
Practice Address - Zip Code:19720-3040
Practice Address - Country:US
Practice Address - Phone:302-322-4444
Practice Address - Fax:302-322-0875
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2012-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEI30001157152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
DECB4722OtherRAILROAD MEDICARE PIN
DE410033511OtherRAILROAD MEDICARE PIN
DE197328742OtherBC/BS ID
DE418103K95Medicare PIN
DE410033511OtherRAILROAD MEDICARE PIN
DET26978Medicare UPIN