Provider Demographics
NPI:1457511065
Name:MIDDLEMAN, MATTHEW NATHANIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:NATHANIEL
Last Name:MIDDLEMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1245 PARK AVE
Mailing Address - Street 2:APT 12J
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-1735
Mailing Address - Country:US
Mailing Address - Phone:212-828-3919
Mailing Address - Fax:
Practice Address - Street 1:1245 PARK AVE
Practice Address - Street 2:APT 12J
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-1735
Practice Address - Country:US
Practice Address - Phone:212-828-3919
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program