Provider Demographics
NPI:1376913913
Name:TAURONE, MATTHEW GABRIELE
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GABRIELE
Last Name:TAURONE
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 1:112 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2208
Mailing Address - Country:US
Mailing Address - Phone:732-841-7485
Mailing Address - Fax:
Practice Address - Street 1:112 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2208
Practice Address - Country:US
Practice Address - Phone:732-841-7485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-25
Last Update Date:2015-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJT08955296702932390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program