Provider Demographics
NPI:1497059893
Name:MORICI, MATTHEW PETER (DPT)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:PETER
Last Name:MORICI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:661 STOWE AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1704
Mailing Address - Country:US
Mailing Address - Phone:516-996-8703
Mailing Address - Fax:
Practice Address - Street 1:661 STOWE AVE
Practice Address - Street 2:
Practice Address - City:NORTH BALDWIN
Practice Address - State:NY
Practice Address - Zip Code:11510-1704
Practice Address - Country:US
Practice Address - Phone:516-996-8703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-29
Last Update Date:2010-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist