Provider Demographics
NPI:1619616067
Name:DIGIORGIO, MATTHEW CARMEN (MS , ATC)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:CARMEN
Last Name:DIGIORGIO
Suffix:
Gender:M
Credentials:MS , ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4226 MAYS AVE
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-7969
Mailing Address - Country:US
Mailing Address - Phone:856-305-5683
Mailing Address - Fax:
Practice Address - Street 1:4226 MAYS AVE
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-7969
Practice Address - Country:US
Practice Address - Phone:856-305-5683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer