Provider Demographics
NPI:1487017992
Name:NATANSON, MATTHEW (PT, DPT, OCS)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:
Last Name:NATANSON
Suffix:
Gender:M
Credentials:PT, DPT, OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 GORDON STREET
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02144-1110
Mailing Address - Country:US
Mailing Address - Phone:978-505-1768
Mailing Address - Fax:
Practice Address - Street 1:26 GORDON STREET
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02144-1110
Practice Address - Country:US
Practice Address - Phone:978-505-1768
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-01
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA19899261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy