Provider Demographics
NPI:1477684991
Name:PORTADIN, MATTHEW ANDREW (PSYD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:ANDREW
Last Name:PORTADIN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 71ST ST
Mailing Address - Street 2:
Mailing Address - City:SEA ISLE CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08243-1314
Mailing Address - Country:US
Mailing Address - Phone:609-263-1368
Mailing Address - Fax:
Practice Address - Street 1:128 CREST HAVEN RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY COURT HOUSE
Practice Address - State:NJ
Practice Address - Zip Code:08210-1651
Practice Address - Country:US
Practice Address - Phone:609-465-4100
Practice Address - Fax:609-465-2588
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist