Provider Demographics
NPI:1508205873
Name:MATTHEWS, DON SCOTT (OT)
Entity Type:Individual
Prefix:
First Name:DON
Middle Name:SCOTT
Last Name:MATTHEWS
Suffix:
Gender:M
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 FAIRFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:WEST CALDWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07006-7603
Mailing Address - Country:US
Mailing Address - Phone:973-771-1582
Mailing Address - Fax:973-337-2213
Practice Address - Street 1:31 FAIRFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7603
Practice Address - Country:US
Practice Address - Phone:973-771-1582
Practice Address - Fax:973-337-2213
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00074900225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0659967Medicaid