Provider Demographics
NPI:1659801512
Name:ANTONELLO, MATTHEW J (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:J
Last Name:ANTONELLO
Suffix:
Gender:M
Credentials:MD, MPH
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Mailing Address - Street 1:44 MACDONOUGH ST APT 4B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11216-2364
Mailing Address - Country:US
Mailing Address - Phone:267-210-5249
Mailing Address - Fax:
Practice Address - Street 1:1 PARK AVE FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5802
Practice Address - Country:US
Practice Address - Phone:212-263-7419
Practice Address - Fax:212-263-7460
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2022-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY3014392084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry