Provider Demographics
NPI:1467158212
Name:CINELLI, MATTHEW NICHOLAS
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:NICHOLAS
Last Name:CINELLI
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 1:9 FRIEND ST
Mailing Address - Street 2:
Mailing Address - City:PORT READING
Mailing Address - State:NJ
Mailing Address - Zip Code:07064-1211
Mailing Address - Country:US
Mailing Address - Phone:732-425-0076
Mailing Address - Fax:
Practice Address - Street 1:9 FRIEND ST
Practice Address - Street 2:
Practice Address - City:PORT READING
Practice Address - State:NJ
Practice Address - Zip Code:07064-1211
Practice Address - Country:US
Practice Address - Phone:732-425-0076
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer